Organization Active NPI

Anesthesiology of Indianapolis, PC

  • Anesthesiology Physician
  • Lebanon, IN
National Provider Identifier
1104877745
Registry record updated May 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
ANESTHESIOLOGY OF INDIANAPOLIS, PC
Practice address
2605 N Lebanon St
Lebanon, IN 46052-1476
Phone
(866) 282-7905
Fax
(800) 731-0751
NPI assigned
May 15, 2006
Last updated
May 30, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 30, 2019

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

Authorized official

Name
Stephen J Strycker, MDNPI 1801810841
Title
Owner/Authorized Official
Phone
(317) 614-9817

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
Anesthesiology Physician 207L00000X IN Primary

Addresses

Primary practice location

2605 N Lebanon St
Lebanon, IN 46052-1476

Mailing address

PO Box 6069
Dept 87
Indianapolis, IN 46206-6069
Phone (317) 614-9817

Other identifiers 1

IdentifierTypeStateIssuer
200420540AMedicaidIN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050224000191 IN Part B Supplier - Clinic/Group Practice 5092768556 Receives reassigned benefits from 9 practitioners
Practice locations: Lebanon, IN

National Provider Directory

National Provider Directory

Locations

1660 Lafayette Rd
Crawfordsvlle, IN 47933
Phone (765) 359-1660

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

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": "1559174400000",
    "number": "1104877745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6069",
            "address_2": "DEPT 87",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462066069",
            "telephone_number": "317-614-9817",
            "fax_number": "317-614-9655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2605 N LEBANON ST",
            "city": "LEBANON",
            "state": "IN",
            "postal_code": "460521476",
            "telephone_number": "866-282-7905",
            "fax_number": "800-731-0751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANESTHESIOLOGY OF INDIANAPOLIS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-15",
        "last_updated": "2019-05-30",
        "status": "A",
        "authorized_official_last_name": "STRYCKER",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER/AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "317-614-9817",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200420540A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lebanon, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2019; 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.