Active NPI
Michael A Agostino, MD
- Otolaryngology Physician
- Noblesville, IN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Otolaryngology Physician
- License
- 01038563
- Practice address
- 18051 River Road
Suite 104
Noblesville, IN 46062-7093 - Phone
- (317) 844-7059
- Fax
- (317) 819-0044
- NPI assigned
- Jun 23, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Otolaryngology Physician | 207Y00000X | 01038563 | IN | Primary |
Addresses
Primary practice location
18051 River Road
Suite 104
Noblesville, IN 46062-7093
Mailing address
10201 N Illinois St Ste 110
Carmel, IN 46290-1172
Phone (317) 844-7059
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100361740A | Medicaid | IN | |
| 000000085510 | Other | IN | ANTHEM PIN |
| 01038563 | Other | IN | LICENSE |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | MAGOSTINO@OA2046.SRS-DIRECT.COM | Direct | Otolaryngology Associates, LLC |
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01038563 | IN | MD | Otolaryngology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Community Physicians of Indiana Inc | Current | Accepting new patients | |
| Community Physicians of Indiana Inc | Current | Accepting new patients | |
| Otolaryngology Associates, LLC | Otolaryngology | Current | Accepting new patients |
| Otorhinolaryngology, Inc | Past | Accepting new patients | |
| Major Hospital | Past | Accepting new patients |
Locations
5819 Reliable Pkwy
Chicago, IL 60686
3113 Broadway St
Anderson, IN 46012
Phone (765) 298-4660
10201 N Illinois St
Ste 110
Carmel, IN 46290
Phone (317) 819-2825
13100 E 136th St
Ste 1200
Fishers, IN 46037
Phone (317) 573-4370
9002 N Meridian St
Ste 222
Indianapolis, IN 46260
Phone (317) 573-4370
7120 Clearvista Dr
Ste 4000
Indianapolis, IN 46256
Phone (317) 621-7444
18051 River Rd
Ste 104
Noblesville, IN 46062
Phone (317) 573-4370
Interoperability endpoints
- magostino@oa2046.srs-direct.com
- https://fhir4.healow.com/fhir/r4/IEEADA
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.
-
- Family Medicine Physician
- Indianapolis, IN
- NPI 1619105244
-
- Otolaryngology Physician
- Indianapolis, IN
- NPI 1447398839
-
- Endocrinology, Diabetes & Metabolism Physician
- Carmel, IN
- NPI 1992396337
-
- General Acute Care Hospital
- Shelbyville, IN
- NPI 1174555692
-
- Specialist
- South Bend, IN
- NPI 1942246822
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151020800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1718928000000",
"number": "1164458352",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10201 N ILLINOIS ST STE 110",
"city": "CARMEL",
"state": "IN",
"postal_code": "462901172",
"telephone_number": "317-844-7059",
"fax_number": "317-819-0044"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "18051 RIVER ROAD",
"address_2": "SUITE 104",
"city": "NOBLESVILLE",
"state": "IN",
"postal_code": "460627093",
"telephone_number": "317-844-7059",
"fax_number": "317-819-0044"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AGOSTINO",
"first_name": "MICHAEL",
"middle_name": "A",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-23",
"last_updated": "2024-06-21",
"certification_date": "2024-02-14",
"status": "A"
},
"taxonomies": [
{
"code": "207Y00000X",
"taxonomy_group": "",
"desc": "Otolaryngology",
"state": "IN",
"license": "01038563",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100361740A",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM PIN",
"identifier": "000000085510",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "01038563",
"state": "IN"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "MAGOSTINO@OA2046.SRS-DIRECT.COM",
"affiliation": "Y",
"affiliationName": "Otolaryngology Associates, LLC",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "9002 North Meridian Street",
"address_2": "Suite 222",
"city": "Indianapolis",
"state": "IN",
"country_code": "US",
"postal_code": "462605350",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Noblesville, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.