Individual provider Active NPI

Mara Lebo

  • Student in an Organized Health Care Education/Training Program
  • Indianapolis, IN
National Provider Identifier
1124911557
Registry record updated Jun 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
1121 W Michigan St
Indianapolis, IN 46202-5211
Phone
(317) 274-7433
NPI assigned
Jun 3, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

1121 W Michigan St
Indianapolis, IN 46202-5211

Mailing address

220 N Meridian St Apt 1106
Indianapolis, IN 46204-2377
Phone (217) 521-5004

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260603001678 IN Order and Referring Only - DentistPractitioner - Dentist 7113498882

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1748908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748908800000",
    "number": "1124911557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 N MERIDIAN ST APT 1106",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462042377",
            "telephone_number": "217-521-5004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1121 W MICHIGAN ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462025211",
            "telephone_number": "317-274-7433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEBO",
        "first_name": "MARA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-06-03",
        "last_updated": "2025-06-03",
        "certification_date": "2025-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.