Individual provider Active NPI

Jonathan William Busald Pike, MD

  • Emergency Medicine Physician
  • Indianapolis, IN
National Provider Identifier
1174053862
Registry record updated Jan 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
01083392A Issued in IN
Practice address
1701 N Senate Blvd RM Ag012
Indianapolis, IN 46202-1239
Phone
(317) 962-3525
NPI assigned
Jun 14, 2017
Last updated
Jan 25, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 25, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 11019431A IN
Emergency Medicine Physician 207P00000X 01083392A IN Primary

Addresses

Primary practice location

1701 N Senate Blvd RM Ag012
Indianapolis, IN 46202-1239

Mailing address

1402 Sturm Ave
Indianapolis, IN 46201-3033

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
I20200601000834 IN Practitioner - Emergency Medicine 9638447394 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Indiana University School of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emergency Physicians of Indianapolis, PCGroup PAC ID 2365338480, 18 clinicians

Practice addresses (Care Compare)

8111 S Emerson Ave
Indianapolis, IN 46237-8601
Phone (317) 528-5261

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.82 of 100Reported as group
Quality
91.66
Improvement activities
40
Cost
78.17

Merit-based Incentive Payment System (MIPS)

Final score
87.3 of 100Reported as group
Quality
70.94
Improvement activities
40
Cost
92.94

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11019431AINMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Professionals of Indiana, P.C. Emergency Medicine CurrentSince Jun 1, 2020 Accepting new patients
Cep America LLC Emergency Medicine Current Accepting new patients
Cep America LLC Emergency Medicine CurrentSince Jul 1, 2022 Accepting new patients
Riverview Hospital Emergency Medicine CurrentSince Sep 1, 2022 Accepting new patients
Cep America LLC Emergency Medicine CurrentSince Jul 1, 2022 Accepting new patients
Emergency Physicians of Indianapolis, PC Emergency Medicine CurrentSince Oct 1, 2023 Accepting new patients
Riverview Hospital CurrentSince Sep 1, 2022 Accepting new patients

Locations

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 900-3125

2015 Jackson St
Anderson, IN 46016
Phone (765) 646-8243

9613 E US Highway 36
Avon, IN 46123
Phone (317) 415-5980

14585 Hazel Dell Pkwy
Rm Urgent
Carmel, IN 46033
Phone (317) 214-5030

3700 Washington Ave
Evansville, IN 47714
Phone (812) 232-0021

9690 E 116th St
Fishers, IN 46037
Phone (317) 214-5750

8111 S Emerson Ave
Indianapolis, IN 46237
Phone (317) 528-5261

1201 Hadley Rd
Mooresville, IN 46158
Phone (317) 783-8148

395 Westfield Rd
Noblesville, IN 46060
Phone (317) 218-3136

2412 E Main St
Plainfield, IN 46168
Phone (317) 204-6800

411 W Tipton St
Seymour, IN 47274
Phone (317) 888-3505

1606 N 7th St
Terre Haute, IN 47804
Phone (812) 238-7523

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1497398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579910400000",
    "number": "1174053862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1402 STURM AVE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462013033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 N SENATE BLVD RM AG012",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462021239",
            "telephone_number": "317-962-3525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PIKE",
        "first_name": "JONATHAN",
        "middle_name": "WILLIAM BUSALD",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-06-14",
        "last_updated": "2020-01-25",
        "certification_date": "2020-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "IN",
            "license": "11019431A",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IN",
            "license": "01083392A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.