NPIMap

Individual provider Active NPI

Philip M Dulberger, M.D.

  • Anesthesiology Physician
  • Fishers, IN
National Provider Identifier
1154315463
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
01042653 Issued in IN
Practice address
9899 E 126TH St
Fishers, IN 46038-2821
Phone
(317) 567-2179
Fax
(317) 567-2191
NPI assigned
Sep 1, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 01042653 IN Primary

Addresses

Primary practice location

9899 E 126TH St
Fishers, IN 46038-2821

Mailing address

1500 N Ritter Ave
Indianapolis, IN 46219-3027
Phone (317) 567-2179

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251111002101 SC Practitioner - Anesthesiology 6204197874 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Indiana University School of Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tidelands Anesthesia Group LLC 51 clinicians

Practice addresses (Care Compare)

606 Black River Rd
Georgetown, SC 29440-3304
Phone (843) 527-7100

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01042653INMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tidelands Health Market Common LLC Current Accepting new patients
Tidelands Anesthesia Group LLC Anesthesiology CurrentSince Aug 3, 2025 Accepting new patients
Tidelands Health ASC LLC CurrentSince Jan 18, 2021 Accepting new patients
Tidelands and Medquest Joint Venture, LLC Current Accepting new patients
Georgetown Memorial Hospital PastSince Sep 9, 2013 Accepting new patients

Locations

606 Black River Rd
Georgetown, SC 29440
Phone (843) 527-7000

Ownership & related parties

All facility ownership & control disclosures 7

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Tidelands Waccamaw Community HospitalMurrells Inlet, SC, CCN 420098 Hospital Corporate Officer
W-2 Managing Employee
Operational/Managerial Control		 Sep 9, 2013
Sep 9, 2013
Sep 9, 2013
Tidelands Georgetown Memorial HospitalGeorgetown, SC, CCN 420020 Hospital Corporate Officer
W-2 Managing Employee
Operational/Managerial Control		 Sep 9, 2013
Sep 9, 2013
Sep 9, 2013
Tidelands Georgetown Memorial HospitalGeorgetown, SC, CCN 42U020 Hospital Corporate Officer
W-2 Managing Employee
Operational/Managerial Control		 Mar 1, 2023
Mar 1, 2023
Mar 1, 2023
Tidelands Health Family Medicine at GeorgetownGeorgetown, SC, CCN 428958 Rural health clinic Corporate Officer
W-2 Managing Employee
Operational/Managerial Control		 Sep 9, 2013
Sep 9, 2013
Sep 9, 2013
Tidelands Health Family Medicine at HemingwayHemingway, SC, CCN 423859 Rural health clinic Corporate Officer
W-2 Managing Employee
Operational/Managerial Control		 Sep 9, 2013
Sep 9, 2013
Sep 9, 2013
Tidelands Health Family MedicineAndrews, SC, CCN 423970 Rural health clinic Corporate Officer
W-2 Managing Employee
Operational/Managerial Control		 Sep 9, 2013
Sep 9, 2013
Sep 9, 2013
Tidelands Health Family Medicine at Pawleys IslandPawleys Island, SC, CCN 423870 Rural health clinic Corporate Officer
W-2 Managing Employee
Operational/Managerial Control		 Sep 9, 2013
Sep 9, 2013
Sep 9, 2013

Owned or controlled facilities with NPI records 7

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 5

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": "1125532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1154315463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 N RITTER AVE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462193027",
            "telephone_number": "317-567-2179",
            "fax_number": "317-567-2191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9899 E 126TH ST",
            "city": "FISHERS",
            "state": "IN",
            "postal_code": "460382821",
            "telephone_number": "317-567-2179",
            "fax_number": "317-567-2191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DULBERGER",
        "first_name": "PHILIP",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-01",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IN",
            "license": "01042653",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fishers, IN

Sources for this page

Verify at the official NPI Registry.