NPIMap

Organization Active NPI

Naab Road Surgical Group PC

  • Surgery Physician
  • Indianapolis, IN
National Provider Identifier
1083762660
Registry record updated Aug 3, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
50003162A Issued in IN
Legal business name
NAAB ROAD SURGICAL GROUP PC
Practice address
8240 Naab Road
Suite 100
Indianapolis, IN 46260
Phone
(317) 338-7450
Fax
(317) 338-7457
NPI assigned
Jan 8, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2018

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

Authorized official

Name
Dr. Mark A Edwards, M.D.NPI 1669471736
Title
Authorized Official
Phone
(317) 338-7450

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208600000X 50003162A IN Primary

Addresses

Primary practice location

8240 Naab Road
Suite 100
Indianapolis, IN 46260

Mailing address

11541 E Winchester LN
Ellicott City, MD 21042-2040
Phone (833) 220-2685

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050209000860 IN Part B Supplier - Clinic/Group Practice 9133170848 Receives reassigned benefits from 18 practitioners
Practice locations: Indianapolis, IN

National Provider Directory

National Provider Directory

Locations

7981 Reliable Pkwy
Chicago, IL 60686

8240 Naab Rd
Ste 100
Indianapolis, IN 46260
Phone (317) 338-7450

Practitioners & affiliated clinicians

Practitioners 18

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1533254400000",
    "number": "1083762660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11541 E WINCHESTER LN",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210422040",
            "telephone_number": "833-220-2685",
            "fax_number": "317-947-0839"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8240 NAAB ROAD",
            "address_2": "SUITE 100",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "46260",
            "telephone_number": "317-338-7450",
            "fax_number": "317-338-7457"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NAAB ROAD SURGICAL GROUP PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-08",
        "last_updated": "2018-08-03",
        "status": "A",
        "authorized_official_last_name": "EDWARDS",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "317-338-7450",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "IN",
            "license": "50003162A",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Aug 3, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.