Organization Active NPI

University Urologists, Inc., PC

  • Urology Physician
  • Indianapolis, IN
National Provider Identifier
1104877141
Registry record updated Jan 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
01048495A Issued in IN
Legal business name
UNIVERSITY UROLOGISTS, INC., PC
Practice address
535 Barnhill Dr Ste 420
Indianapolis, IN 46202-5116
Phone
(317) 278-1979
Fax
(317) 278-1981
NPI assigned
May 15, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2024

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

Authorized official

Name
Dr. Michael O Koch, MDNPI 1821084252
Title
President
Phone
(317) 944-7338

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Urology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 208800000X 01048495A IN Primary
Pediatric Urology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2088P0231X 01048495A IN
Pediatric Nurse PractitionerGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 363LP0200X 71001248A IN

Addresses

Primary practice location

535 Barnhill Dr Ste 420
Indianapolis, IN 46202-5116

Mailing address

250 N Shadeland Ave
Indianapolis, IN 46219-4959
Phone (888) 484-3258

Other identifiers 1

IdentifierTypeStateIssuer
100057570MedicaidIN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040728000391 IN Part B Supplier - Clinic/Group Practice 4284604208 Receives reassigned benefits from 61 practitioners
Practice locations: Indianapolis, IN; Lafayette, IN; Lowell, IN; Newburgh, IN; Richmond, IN; Terre Haute, IN; Tipton, IN; Carmel, IN…

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

7614 Solutions Ctr
Chicago, IL 60677

11725 Illinois St
Carmel, IN 46032
Phone (317) 617-4808

11725 Illinois St
Ste 450
Carmel, IN 46032
Phone (317) 688-5700

13100 E 136th St
Ste 2400
Fishers, IN 46037
Phone (317) 328-6620

535 Barnhill Dr
#4826
Indianapolis, IN 46202
Phone (317) 274-1772

535 Barnhill Dr
#420
Indianapolis, IN 46202
Phone (317) 274-7071

1550 E County Line Rd
Ste 301
Indianapolis, IN 46227
Phone (317) 621-9210

2600 Greenbush St
Fl 1
Lafayette, IN 47904
Phone (317) 944-7446

Practitioners & affiliated clinicians

Practitioners 85

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

View all 85

NPI Registry JSON

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

{
    "created_epoch": "1147651200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1705622400000",
    "number": "1104877141",
    "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",
            "telephone_number": "888-484-3258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "535 BARNHILL DR STE 420",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462025116",
            "telephone_number": "317-278-1979",
            "fax_number": "317-278-1981"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY UROLOGISTS, INC., PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-15",
        "last_updated": "2024-01-19",
        "certification_date": "2024-01-19",
        "status": "A",
        "authorized_official_last_name": "KOCH",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "O",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "317-944-7338",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Urology",
            "state": "IN",
            "license": "01048495A",
            "primary": true
        },
        {
            "code": "2088P0231X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Urology, Pediatric Urology",
            "state": "IN",
            "license": "01048495A",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "IN",
            "license": "71001248A",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100057570",
            "state": "IN"
        }
    ],
    "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 Jan 19, 2024; 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.