Individual provider Active NPI

Frederick W Unverzagt, PHD

  • Psychologist
  • Indianapolis, IN
National Provider Identifier
1154375814
Registry record updated Nov 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
20040645A Issued in IN
Practice address
550 University Blvd # Uh3124
Indianapolis, IN 46202-5149
Phone
(317) 274-1250
NPI assigned
May 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 23, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neurophysiology Physician 2084N0600X 20040645 IN
Psychologist 103T00000X 20040645A IN Primary

Addresses

Primary practice location

550 University Blvd # Uh3124
Indianapolis, IN 46202-5149

Mailing address

250 N Shadeland Ave Ste 200
Indianapolis, IN 46219-4959
Phone (317) 962-3834

Other identifiers 1

IdentifierTypeStateIssuer
100195770MedicaidIN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address FUNVERZAGT@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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040721000628 IN Practitioner - Clinical Psychologist 2365422342 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1991
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

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20040645INMDClinical Neurophysiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Iu Health Medical Group, LLC CurrentSince Jul 1, 2025 Accepting new patients
University Medical Diagnostic Associates, Inc. Past Accepting new patients

Locations

550 University Blvd
#3124
Indianapolis, IN 46202
Phone (317) 274-2855

250 N Shadeland Ave
Ste 200
Indianapolis, IN 46219
Phone (317) 962-4836

355 W 16th St
Ste 4800
Indianapolis, IN 46202
Phone (317) 963-7288

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

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

355 W 16th St
Ste 2800
Indianapolis, IN 46202
Phone (317) 963-7300

250 N Shadeland Ave
Ste 130
Indianapolis, IN 46219
Phone (317) 962-4836

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

Interoperability endpoints

  • Direct secure messaging: funverzagt@direct.iuhealth.org

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": "1147996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606089600000",
    "number": "1154375814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 N SHADELAND AVE STE 200",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462194959",
            "telephone_number": "317-962-3834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 UNIVERSITY BLVD # UH3124",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462025149",
            "telephone_number": "317-274-1250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UNVERZAGT",
        "first_name": "FREDERICK",
        "middle_name": "W",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-19",
        "last_updated": "2020-11-23",
        "certification_date": "2020-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0600X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Clinical Neurophysiology",
            "state": "IN",
            "license": "20040645",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "IN",
            "license": "20040645A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100195770",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "FUNVERZAGT@direct.iuhealth.org",
            "affiliation": "N",
            "address_1": "550 University Blvd # Uh3124",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "462025149",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.