Individual provider Active NPI

Katherine Moravec, DO

  • Student in an Organized Health Care Education/Training Program
  • Indianapolis, IN
National Provider Identifier
1083552467
Registry record updated Jun 19, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
License
11024735A Issued in IN
Practice address
10122 E 10TH St Ste 100
Indianapolis, IN 46229-2697
Phone
(317) 355-5717
Fax
(317) 355-3760
NPI assigned
Mar 24, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 11024735A IN Primary

Addresses

Primary practice location

10122 E 10TH St Ste 100
Indianapolis, IN 46229-2697

Mailing address

10122 E 10TH St Ste 100
Indianapolis, IN 46229-2697

Other practice location 1

1330 Valdosta Dr
Fort Wayne, IN 46825-3588
Phone (260) 443-6698

Other identifiers 1

IdentifierTypeStateIssuer
300132245MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260514002277 IN Order and Referring Only - Family PracticePractitioner - Family Practice 8224507686

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

NPI Registry JSON

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

{
    "created_epoch": "1774310400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781827200000",
    "number": "1083552467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10122 E 10TH ST STE 100",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462292697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10122 E 10TH ST STE 100",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462292697",
            "telephone_number": "317-355-5717",
            "fax_number": "317-355-3760"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1330 Valdosta Dr",
            "address_purpose": "LOCATION",
            "city": "Fort Wayne",
            "state": "IN",
            "postal_code": "468253588",
            "country_code": "US",
            "telephone_number": "260-443-6698",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MORAVEC",
        "first_name": "KATHERINE",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-03-24",
        "last_updated": "2026-06-19",
        "certification_date": "2026-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "IN",
            "license": "11024735A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300132245",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.