NPIMap

Individual provider Active NPI

Mark M Kandary, MD

  • Internal Medicine Physician
  • Indianapolis, IN
National Provider Identifier
1104277235
Registry record updated Jul 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
4301110146 Issued in MI
Practice address
1800 N Capitol Ave
Indianapolis, IN 46202-1218
Phone
(317) 962-2894
Fax
(317) 963-5285
NPI assigned
Jun 30, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 01082592A IN
Nephrology Physician 207RN0300X 4301509009 MI
Internal Medicine Physician 207R00000X 4301110146 MI Primary

Addresses

Primary practice location

1800 N Capitol Ave
Indianapolis, IN 46202-1218

Mailing address

250 N Shadeland Ave
Indianapolis, IN 46219-4959

Other practice location 1

44405 Woodward Ave
Pontiac, MI 48341-5023
Phone (248) 858-6223

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mkandary@direct.iuhealth.org

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230710000331 MI Practitioner - Nephrology 2365729019 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nephrology
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kidney Disease and Hypertension Consultants PCGroup PAC ID 0446251623, 8 clinicians

Practice addresses (Care Compare)

2486 Nerredia St
Suite E
Flint, MI 48532-4807
Phone (810) 230-9901

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301509009MIMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kidney Disease & Hypertension Consultants PC Nephrology CurrentSince Jul 1, 2023 Accepting new patients

Locations

2486 Nerredia St
Ste E
Flint, MI 48532
Phone (313) 800-8230

L 3677
Columbus, OH 43260

Interoperability endpoints

  • Direct secure messaging: mkandary1134057@direct.hfhs.org
  • Direct secure messaging: mkandary@direct.iuhealth.org
  • Direct secure messaging: mkandary149053@direct.covenanthealthcare.com

Organizations & group practices 1

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 9

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": "1467244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689897600000",
    "number": "1104277235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 N SHADELAND AVE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462194959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 N CAPITOL AVE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462021218",
            "telephone_number": "317-962-2894",
            "fax_number": "317-963-5285"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "44405 Woodward Ave",
            "address_purpose": "LOCATION",
            "city": "Pontiac",
            "state": "MI",
            "postal_code": "483415023",
            "country_code": "US",
            "telephone_number": "248-858-6223",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KANDARY",
        "first_name": "MARK",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-30",
        "last_updated": "2023-07-21",
        "certification_date": "2023-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IN",
            "license": "01082592A",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "MI",
            "license": "4301509009",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301110146",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mkandary@direct.iuhealth.org",
            "affiliation": "N",
            "address_1": "1800 N Capitol Ave",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "462021218",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.