Individual provider Active NPI

Lascelles Garvey

  • Physician Assistant
  • Carmel, IN
National Provider Identifier
1093541765
Registry record updated Sep 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
10004533A Issued in IN
Practice address
1424 S Rangeline Rd
Carmel, IN 46032-2934
Phone
(317) 571-1176
NPI assigned
Sep 10, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 10004533A IN Primary

Addresses

Primary practice location

1424 S Rangeline Rd
Carmel, IN 46032-2934

Mailing address

6626 E 75TH St Ste 500
Indianapolis, IN 46250-2890
Phone (317) 621-7584

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241001004059 IN Practitioner - Physician Assistant 1850822867 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Physicians of Indiana IncGroup PAC ID 1759416662, 1,569 clinicians
Community Physician Network Urgent Care LLCGroup PAC ID 1052819869, 80 clinicians

Practice addresses (Care Compare)

200 S Ford Rd
Zionsville, IN 46077-1864
Phone (317) 957-9270

3545 W 86TH St
Indianapolis, IN 46268-1930
Phone (317) 228-0419

489 S State Rd
135 Suite F
Greenwood, IN 46142-1400
Phone (317) 887-7640

650 N Girls School Rd
Indianapolis, IN 46214-3672
Phone (317) 957-9020

675 E Hickory LN
Indianapolis, IN 46227-8512
Phone (317) 497-6390

7120 Clearvista Dr
Suite 4000
Indianapolis, IN 46256-1774
Phone (317) 621-7444

7910 E Washington St
Indianapolis, IN 46219-5563

8177 Clearvista Pkwy
Suite 100
Indianapolis, IN 46256-1662
Phone (317) 621-7800

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
10004533AINMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Community Physicians of Indiana Inc CurrentSince Sep 9, 2024 Accepting new patients

Locations

5819 Reliable Pkwy
Chicago, IL 60686

1424 S Rangeline Rd
Carmel, IN 46032
Phone (317) 571-1176

7120 Clearvista Dr
Ste 4000
Indianapolis, IN 46256
Phone (317) 621-7444

6626 E 75th St
Ste 500
Indianapolis, IN 46250
Phone (317) 621-7547

8177 Clearvista Pkwy
#100
Indianapolis, IN 46256
Phone (317) 621-7800

Interoperability endpoints

  • Direct secure messaging: lgarvey627334@ecommunitydirect.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1725926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725926400000",
    "number": "1093541765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6626 E 75TH ST STE 500",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462502890",
            "telephone_number": "317-621-7584"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1424 S RANGELINE RD",
            "city": "CARMEL",
            "state": "IN",
            "postal_code": "460322934",
            "telephone_number": "317-571-1176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARVEY",
        "first_name": "LASCELLES",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-09-10",
        "last_updated": "2024-09-10",
        "certification_date": "2024-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IN",
            "license": "10004533A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carmel, IN

Sources for this page

Verify at the official NPI Registry.