Individual provider Active NPI

L T Gates, MD

  • Family Medicine Physician
  • Indianapolis, IN
National Provider Identifier
1124040464
Registry record updated Feb 1, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
01037135A Issued in IN
Practice address
2920 N Arlington Ave
Suite B
Indianapolis, IN 46218-3362
Phone
(317) 355-9431
Fax
(317) 355-9445
NPI assigned
Jul 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 01037135A IN Primary

Addresses

Primary practice location

2920 N Arlington Ave
Suite B
Indianapolis, IN 46218-3362

Mailing address

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

Other identifiers 3

IdentifierTypeStateIssuer
000000313170OtherINANTHEM
P00235875OtherINRR MEDICARE
100068290MedicaidIN

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
I20040324000799 IN Practitioner - Family Practice 5597656868 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01037135AINMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Community Physicians of Indiana Inc Family Medicine CurrentSince May 18, 2011 Accepting new patients
Community Physicians of Indiana Inc CurrentSince May 18, 2011 Accepting new patients
Major Hospital Past Accepting new patients

Locations

5819 Reliable Pkwy
Chicago, IL 60686

1030 S Scatterfield Rd
Anderson, IN 46012
Phone (765) 644-5025

11911 N Meridian St
Ste 150
Carmel, IN 46032
Phone (317) 621-6700

1664 W Smith Valley Rd
Greenwood, IN 46142
Phone (317) 887-7640

1703 N Post Rd
Indianapolis, IN 46219
Phone (317) 355-3200

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

2920 N Arlington Ave
Ste B
Indianapolis, IN 46218
Phone (317) 355-9431

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

9669 E 146th St
Ste 100
Noblesville, IN 46060
Phone (317) 621-3434

Interoperability endpoints

  • Direct secure messaging: lgates10771@ecommunitydirect.com

Organizations & group practices 3

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": "1153699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485907200000",
    "number": "1124040464",
    "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": "2920 N ARLINGTON AVE",
            "address_2": "SUITE B",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462183362",
            "telephone_number": "317-355-9431",
            "fax_number": "317-355-9445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GATES",
        "first_name": "L",
        "middle_name": "T",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-24",
        "last_updated": "2017-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01037135A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000313170",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00235875",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100068290",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.