Individual provider Active NPI

Cassidy Anne Overpeck, MD

  • Internal Medicine Physician
  • Indianapolis, IN
National Provider Identifier
1184036931
Registry record updated May 12, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
01078527A Issued in IN
Practice address
1120 W Michigan St
Gatch Hall CL 630
Indianapolis, IN 46202-5209
Phone
(800) 362-2066
NPI assigned
May 28, 2014
Last updated
May 12, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 12, 2017

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 11017639A IN
Internal Medicine Physician 207R00000X 01078527A IN Primary

Addresses

Primary practice location

1120 W Michigan St
Gatch Hall CL 630
Indianapolis, IN 46202-5209

Mailing address

1120 W Michigan St
Gatch Hall CL 630
Indianapolis, IN 46202-5209
Phone (800) 362-2066

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
I20140707000466 IN Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 2466677505

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01078527AINMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Major Hospital Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1401235200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1494547200000",
    "number": "1184036931",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1120 W MICHIGAN ST",
            "address_2": "GATCH HALL CL 630",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462025209",
            "telephone_number": "800-362-2066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 W MICHIGAN ST",
            "address_2": "GATCH HALL CL 630",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462025209",
            "telephone_number": "800-362-2066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OVERPECK",
        "first_name": "CASSIDY",
        "middle_name": "ANNE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-05-28",
        "last_updated": "2017-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "IN",
            "license": "11017639A",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IN",
            "license": "01078527A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.