Individual provider Active NPI

Stephen Alan Rappaport, M.D.

  • Internal Medicine Physician
  • Indianapolis, IN
National Provider Identifier
1124248935
Registry record updated May 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
01032429A Issued in IN
Practice address
9292 N Meridian St
Suite 107
Indianapolis, IN 46260-1857
Phone
(317) 846-9792
NPI assigned
Apr 26, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 15, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 01032429A IN Primary
Geriatric Medicine (Internal Medicine) Physician 207RG0300X 01032429A IN

Addresses

Primary practice location

9292 N Meridian St
Suite 107
Indianapolis, IN 46260-1857

Mailing address

8025 Broadway St
Indianapolis, IN 46240-2502
Phone (317) 254-1617

Other identifiers 1

IdentifierTypeStateIssuer
100228190AMedicaidIN

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
I20060213000804 IN Practitioner - Geriatric MedicinePractitioner - Internal Medicine 3476568411 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01032429AINMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Witham Memorial Hospital CurrentSince Nov 17, 2024 Accepting new patients
Witham Memorial Hospital CurrentSince Nov 17, 2024 Accepting new patients
Advanced Healthcare Associates LLP Internal Medicine CurrentSince Aug 2, 2011 Accepting new patients

Locations

2300 Parkview Ln
Elwood, IN 46036
Phone (765) 203-2672

3834 S Emerson Ave
Ste C
Indianapolis, IN 46203
Phone (317) 782-1577

2505 N Lebanon St
Ste 220
Lebanon, IN 46052
Phone (765) 482-8649

2605 N Lebanon St
Lebanon, IN 46052
Phone (765) 485-8000

701 S Main St
Summitville, IN 46070
Phone (765) 203-2671

6085 Heartland Dr
Ste 204
Zionsville, IN 46077
Phone (317) 768-2134

Interoperability endpoints

  • Direct secure messaging: srappaport47268@direct.franciscanalliance.org

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": "1177545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210809600000",
    "number": "1124248935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8025 BROADWAY ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462402502",
            "telephone_number": "317-254-1617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9292 N MERIDIAN ST",
            "address_2": "SUITE 107",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462601857",
            "telephone_number": "317-846-9792"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAPPAPORT",
        "first_name": "STEPHEN",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-26",
        "last_updated": "2008-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IN",
            "license": "01032429A",
            "primary": true
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "IN",
            "license": "01032429A",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100228190A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.