Active NPI
Eli R Hallal, M.D.
- Family Medicine Physician
- New Albany, IN
National Provider Identifier
1083614416
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 01025361A
- Practice address
- 1964 State St
Suite 100
New Albany, IN 47150-4934 - Phone
- (812) 948-1641
- Fax
- (812) 941-0438
- NPI assigned
- Jul 28, 2005
- Last updated
- Mar 15, 2011
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 01025361A | IN | Primary |
Addresses
Primary practice location
1964 State St
Suite 100
New Albany, IN 47150-4934
Mailing address
1964 State St
Suite 100
New Albany, IN 47150-4934
Phone (812) 948-1641
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 35135957500 | Other | OH | OHIO BUREAU OF WORKERS' C |
| 351359575 | Other | IN | COMMERCIAL |
| 000000042312 | Other | IN | ANTHEM |
| 100115500A | Medicaid | IN | |
| I001704 | Other | IN | TRICARE /CHAMPUS |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110308000796 | IN | Practitioner - Family Practice | 3072685593 | Practice locations: New Albany, IN |
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- Indiana University School of Medicine, 1973
- Medicare assignment
- May accept Medicare assignment
- Group practices
Practice addresses (Care Compare)
2 Silvercrest Dr
Suite 100
New Albany, IN 47150-7800
Phone (812) 948-1641
2125 State St
Suite 2
New Albany, IN 47150-4972
Hospital & facility affiliations
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of skin lesions | 1-10 |
| Removal or shaving of skin growth | 1-10 |
| Skin biopsy | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Amy Hallal Henderson MD LLC | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Physical Therapy Clinic/Center
- New Albany, IN
- NPI 1003824772
-
- General Practice Physician
- New Albany, IN
- NPI 1528459278
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Baptist Health Floyd
- General Acute Care Hospital
- New Albany, IN
- NPI 1497798847
-
dba CommonSpirit Health at Home - Clarksville
- Home Health Agency
- Clarksville, IN
- NPI 1801149455
-
dba Baptist Health La Grange
- General Acute Care Hospital
- La Grange, KY
- NPI 1306925540
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1122508800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1300147200000",
"number": "1083614416",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1964 STATE ST",
"address_2": "SUITE 100",
"city": "NEW ALBANY",
"state": "IN",
"postal_code": "471504934",
"telephone_number": "812-948-1641",
"fax_number": "812-941-0438"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1964 STATE ST",
"address_2": "SUITE 100",
"city": "NEW ALBANY",
"state": "IN",
"postal_code": "471504934",
"telephone_number": "812-948-1641",
"fax_number": "812-941-0438"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HALLAL",
"first_name": "ELI",
"middle_name": "R",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-07-28",
"last_updated": "2011-03-15",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "IN",
"license": "01025361A",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OHIO BUREAU OF WORKERS' C",
"identifier": "35135957500",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "COMMERCIAL",
"identifier": "351359575",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM",
"identifier": "000000042312",
"state": "IN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100115500A",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TRICARE /CHAMPUS",
"identifier": "I001704",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}Other providers in New Albany, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.