Individual provider Active NPI

Elliot Levine, PA

  • Physician Assistant
  • Indianapolis, IN
National Provider Identifier
1144395807
Registry record updated Jan 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
10000885 Issued in IN
Practice address
355 W 16TH St
Suite 5100
Indianapolis, IN 46202-2207
Phone
(317) 396-1300
Fax
(317) 924-8472
NPI assigned
Nov 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 10000885 IN Primary

Addresses

Primary practice location

355 W 16TH St
Suite 5100
Indianapolis, IN 46202-2207

Mailing address

8333 Naab Rd
Ste 255
Indianapolis, IN 46260-5924
Phone (317) 396-1300

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address elevine@direct.iuhealth.org

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070529000434 IN Practitioner - Physician Assistant 9638276561 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Iu Health Medical Group LLCGroup PAC ID 9638617913, 4,382 clinicians

Practice addresses (Care Compare)

1701 N Senate Blvd
Indianapolis, IN 46202-1239
Phone (888) 484-3258

355 W 16TH St
Suite 5100
Indianapolis, IN 46202-2274
Phone (888) 484-3258

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
10000885INMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
University Family Physicians, Inc. CurrentSince Sep 1, 2019 Accepting new patients
Major Hospital Past Accepting new patients

Locations

7216 Solutions Ctr
Chicago, IL 60677

355 W 16th St
Ste 5100
Indianapolis, IN 46202
Phone (317) 963-8145

1701 Senate Blvd
Indianapolis, IN 46202
Phone (317) 612-2754

355 W 16th St
Indianapolis, IN 46202
Phone (317) 963-7070

250 N Shadeland Ave
Indianapolis, IN 46219
Phone (317) 948-9174

1520 N Senate Ave
Indianapolis, IN 46202
Phone (317) 962-0857

Interoperability endpoints

  • Direct secure messaging: elevine@direct.iuhealth.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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1164067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610668800000",
    "number": "1144395807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8333 NAAB RD",
            "address_2": "STE 255",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462605924",
            "telephone_number": "317-396-1300",
            "fax_number": "317-396-1346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "355 W 16TH ST",
            "address_2": "SUITE 5100",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462022207",
            "telephone_number": "317-396-1300",
            "fax_number": "317-924-8472"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEVINE",
        "first_name": "ELLIOT",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-21",
        "last_updated": "2021-01-15",
        "certification_date": "2021-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IN",
            "license": "10000885",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "elevine@direct.iuhealth.org",
            "affiliation": "N",
            "address_1": "355 W 16th St",
            "address_2": "Suite 5100",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "462022207",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.