Individual provider Active NPI

Mark H Stein, MD

  • Pediatrics Physician
  • Indianapolis, IN
National Provider Identifier
1063405397
Registry record updated Mar 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
01025781 Issued in IN
Practice address
8330 Naab Rd
Ste 307
Indianapolis, IN 46260-5925
Phone
(317) 872-0400
Fax
(317) 872-9577
NPI assigned
Aug 23, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 19, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 01025781 IN Primary

Addresses

Primary practice location

8330 Naab Rd
Ste 307
Indianapolis, IN 46260-5925

Mailing address

8330 Naab Rd
Ste 307
Indianapolis, IN 46260-5925
Phone (317) 872-0400

Other identifiers 1

IdentifierTypeStateIssuer
100059920AMedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
01025781INMDPediatrics Physician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1124755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552953600000",
    "number": "1063405397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8330 NAAB RD",
            "address_2": "STE 307",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462605925",
            "telephone_number": "317-872-0400",
            "fax_number": "317-872-9577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8330 NAAB RD",
            "address_2": "STE 307",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462605925",
            "telephone_number": "317-872-0400",
            "fax_number": "317-872-9577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEIN",
        "first_name": "MARK",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-23",
        "last_updated": "2019-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IN",
            "license": "01025781",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100059920A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.