Individual provider Active NPI

Daniel James Fisher, MD

  • Family Medicine Physician
  • Indianapolis, IN
National Provider Identifier
1104137116
Registry record updated Jun 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
01070949A Issued in IN
Practice address
10122 E 10TH St
Suite 100
Indianapolis, IN 46229-2663
Phone
(317) 355-5717
Fax
(317) 355-3760
NPI assigned
Jun 24, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 11015552A IN
Family Medicine Physician 207Q00000X 01070949A IN Primary

Addresses

Primary practice location

10122 E 10TH St
Suite 100
Indianapolis, IN 46229-2663

Mailing address

6626 E 75TH St
Suite 500
Indianapolis, IN 46250-2805

Other identifiers 2

IdentifierTypeStateIssuer
201061920MedicaidIN
P01221095OtherINRR MEDICARE PTAN

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
I20130805000887 IN Practitioner - Family Practice 2264671890 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Indiana University School of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Physicians of Indiana Inc 1,569 clinicians

Practice addresses (Care Compare)

10122 E 10TH St
Suite 100
Indianapolis, IN 46229-2697
Phone (317) 355-5717

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

Hospital & facility affiliations

  • Indiana University Health Bedford Hospital Hospital, Bedford, IN, CCN 151328
  • Indiana University Health Bloomington Hospital Hospital, Bloomington, IN, CCN 150051
  • Indiana University Health Hospital, Indianapolis, IN, CCN 150056
  • Community Hospital East Hospital, Indianapolis, IN, CCN 150074
  • Community Hospital North Hospital, Indianapolis, IN, CCN 150169

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01070949AINMDFamily Medicine Physician
11015552AINMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Community Physicians of Indiana Inc CurrentSince Aug 26, 2013 Accepting new patients
Community Physicians of Indiana Inc Family Medicine CurrentSince Aug 26, 2013 Accepting new patients
Major Hospital Past Accepting new patients

Locations

5819 Reliable Pkwy
Chicago, IL 60686

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

10122 E 10th St
Ste 100
Indianapolis, IN 46229
Phone (317) 355-5717

2040 N Shadeland Ave
Ste 300
Indianapolis, IN 46219
Phone (317) 355-3232

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

Interoperability endpoints

  • Direct secure messaging: dfisher316965@direct.ochin.org
  • Direct secure messaging: dfisher11798@ecommunitydirect.com

Organizations & group practices 4

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1277337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623196800000",
    "number": "1104137116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6626 E 75TH ST",
            "address_2": "SUITE 500",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462502805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10122 E 10TH ST",
            "address_2": "SUITE 100",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462292663",
            "telephone_number": "317-355-5717",
            "fax_number": "317-355-3760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FISHER",
        "first_name": "DANIEL",
        "middle_name": "JAMES",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-06-24",
        "last_updated": "2021-06-09",
        "certification_date": "2021-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "IN",
            "license": "11015552A",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01070949A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201061920",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE PTAN",
            "identifier": "P01221095",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.