Individual provider Active NPI

Liza L Ilag, MD

  • Endocrinology, Diabetes & Metabolism Physician
  • Indianapolis, IN
National Provider Identifier
1154499630
Registry record updated Mar 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
01061472A Issued in IN
Practice address
720 Eskenazi Ave
Indianapolis, IN 46202-5187
Phone
(317) 630-6662
NPI assigned
Dec 1, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2025

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 01061472A IN
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 01061472A IN Primary

Addresses

Primary practice location

720 Eskenazi Ave
Indianapolis, IN 46202-5187

Mailing address

250 N Shadeland Ave
Indianapolis, IN 46219-4959

Other practice location 1

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

Other identifiers 3

IdentifierTypeStateIssuer
000001024674OtherINANTHEM PTAN
1102395240OtherINANTHEM PTAN
201362850MedicaidIN

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address lilag@direct.iuhealth.org Direct
Direct Messaging Address lilag@direct.iuhealth.org Direct

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
I20160616000214 IN Practitioner - EndocrinologyPractitioner - Internal Medicine 6406147776 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01061472AINMDEndocrinology, Diabetes & Metabolism Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Medical Diagnostic Associates, Inc. Internal Medicine CurrentSince Jul 14, 2024 Accepting new patients
Iu Health Medical Group, LLC CurrentSince Apr 1, 2025 Accepting new patients
Indiana University Health Care Associates, Inc CurrentSince May 14, 2016 Accepting new patients

Locations

5208 Reliable Pkwy
Chicago, IL 60686

7301 Solutions Ctr
Chicago, IL 60677

1701 N Senate Blvd
Bldg C6
Indianapolis, IN 46202
Phone (913) 962-2000

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

550 University Blvd
Indianapolis, IN 46202
Phone (217) 274-5000

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

720 Eskenazi Ave
Indianapolis, IN 46202
Phone (317) 880-0000

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

Interoperability endpoints

  • Direct secure messaging: lilag@direct.iuhealth.org
  • Direct secure messaging: lilag13757@direct.eskenazihealth.edu

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.

NPI Registry JSON

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

{
    "created_epoch": "1164931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741564800000",
    "number": "1154499630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 N SHADELAND AVE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462194959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 ESKENAZI AVE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462025187",
            "telephone_number": "317-630-6662"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1701 N Senate Blvd",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462021239",
            "country_code": "US",
            "telephone_number": "888-484-3258",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ILAG",
        "first_name": "LIZA",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-01",
        "last_updated": "2025-03-10",
        "certification_date": "2025-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IN",
            "license": "01061472A",
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "IN",
            "license": "01061472A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM PTAN",
            "identifier": "000001024674",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM PTAN",
            "identifier": "1102395240",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201362850",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lilag@direct.iuhealth.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "720 Eskenazi Ave",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "462025187",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lilag@direct.iuhealth.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1701 N Senate Blvd",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "462021239",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.