NPIMap

Organization Active NPI

Endocrinology & Diabetes of Indiana LLC

  • Endocrinology, Diabetes & Metabolism Physician
  • Indianapolis, IN
National Provider Identifier
1154833002
Registry record updated Nov 1, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
01040236A Issued in IN
Legal business name
ENDOCRINOLOGY & DIABETES OF INDIANA LLC
Practice address
9240 N Meridian St Ste 240
Indianapolis, IN 46260-1876
Phone
(317) 571-0030
Fax
(317) 219-4690
NPI assigned
Nov 1, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2017

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

Authorized official

Name
Moazzam Habib, MDNPI 1639270721
Title
President
Phone
(317) 590-2604

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RE0101X 01040236A IN Primary

Addresses

Primary practice location

9240 N Meridian St Ste 240
Indianapolis, IN 46260-1876

Mailing address

9240 N Meridian St Ste 240
Indianapolis, IN 46260-1876
Phone (317) 571-0030

National Provider Directory

National Provider Directory

Locations

9240 N Meridian St
Ste 240
Indianapolis, IN 46260
Phone (317) 571-0030

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1509494400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1509494400000",
    "number": "1154833002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9240 N MERIDIAN ST STE 240",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462601876",
            "telephone_number": "317-571-0030",
            "fax_number": "317-219-4690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9240 N MERIDIAN ST STE 240",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462601876",
            "telephone_number": "317-571-0030",
            "fax_number": "317-219-4690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENDOCRINOLOGY & DIABETES OF INDIANA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-01",
        "last_updated": "2017-11-01",
        "status": "A",
        "authorized_official_last_name": "HABIB",
        "authorized_official_first_name": "MOAZZAM",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "317-590-2604",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "IN",
            "license": "01040236A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.