Individual provider Active NPI

Peiguang Tyler Xie, MD

  • Hospitalist Physician
  • Indianapolis, IN
National Provider Identifier
1144293150
Registry record updated Dec 8, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
01058468A Issued in IN
Practice address
1400 N Ritter Ave
Suite 375B
Indianapolis, IN 46219-3052
Phone
(317) 355-9370
Fax
(317) 621-5678
NPI assigned
Feb 9, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2014

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 01058468A IN
Hospitalist Physician 208M00000X 01058468A IN Primary

Addresses

Primary practice location

1400 N Ritter Ave
Suite 375B
Indianapolis, IN 46219-3052

Mailing address

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

Other identifiers 3

IdentifierTypeStateIssuer
200511010MedicaidIN
P01214638OtherINRR MEDICARE PTAN
P01148174OtherINRR MEDICARE PTAN

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
I20050920000948 IN Practitioner - Internal MedicinePractitioner - Hospitalist 3870527849 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01058468AINMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Community Physicians of Indiana Inc CurrentSince Mar 13, 2013 Accepting new patients
Community Physicians of Indiana Inc Internal Medicine CurrentSince Mar 13, 2013 Accepting new patients

Locations

5819 Reliable Pkwy
Chicago, IL 60686

1315 N Arlington Ave
Ste 100
Indianapolis, IN 46219
Phone (317) 322-2392

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

1400 N Ritter Ave
Ste 231
Indianapolis, IN 46219
Phone (317) 621-4657

1500 N Ritter Ave
Indianapolis, IN 46219
Phone (317) 355-5041

1400 N Ritter Ave
Ste 375B
Indianapolis, IN 46219
Phone (317) 355-9370

325 Westfield Rd
Ste A
Noblesville, IN 46060
Phone (317) 353-9336

Interoperability endpoints

  • Direct secure messaging: pxie31254@ecommunitydirect.com

Organizations & group practices 2

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": "1139443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1417996800000",
    "number": "1144293150",
    "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": "1400 N RITTER AVE",
            "address_2": "SUITE 375B",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462193052",
            "telephone_number": "317-355-9370",
            "fax_number": "317-621-5678"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "XIE",
        "first_name": "PEIGUANG",
        "middle_name": "TYLER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-09",
        "last_updated": "2014-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IN",
            "license": "01058468A",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "IN",
            "license": "01058468A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200511010",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE PTAN",
            "identifier": "P01214638",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE PTAN",
            "identifier": "P01148174",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.