Individual provider Active NPI

Elham Zayed, MD

  • Dermatology Physician
  • Indianapolis, IN
National Provider Identifier
1194450577
Registry record updated Oct 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
01094652A Issued in IN
Practice address
1701 N Senate Blvd
Indianapolis, IN 46202-1239
Phone
(317) 948-8657
Fax
(317) 948-5949
NPI assigned
Jul 20, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dermatology Physician 207NP0225X 57253800 OH
Dermatology Physician 207N00000X 01094652A IN Primary

Addresses

Primary practice location

1701 N Senate Blvd
Indianapolis, IN 46202-1239

Mailing address

250 N Shadeland Ave
Indianapolis, IN 46219-4959

Other practice location 1

555 S 18th St
Columbus, OH 43205-2654
Phone (614) 722-5423

Other identifiers 1

IdentifierTypeStateIssuer
1104407961OtherINANTHEM PTAN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ezayed@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
I20241018002546 IN Practitioner - Dermatology 3072984954 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Iu Health Medical Group Riley Specialists LLCGroup PAC ID 9638669815, 285 clinicians

Practice addresses (Care Compare)

705 Riley Hospital Dr
Indianapolis, IN 46202-5109
Phone (888) 484-3258

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01094652AINMDDermatology Physician
57253800OHMDPediatric Dermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Iu Health Medical Group, LLC CurrentSince Oct 1, 2024 Accepting new patients
Iu Health Medical Group Riley Specialists, LLC CurrentSince Jan 1, 2026 Accepting new patients

Locations

13100 E 136th St
Fishers, IN 46037
Phone (317) 678-2000

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

705 Riley Hospital Dr
Indianapolis, IN 46202
Phone (317) 274-4779

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

Interoperability endpoints

  • Direct secure messaging: ezayed@direct.iuhealth.org

Organizations & group practices 2

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": "1658275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728604800000",
    "number": "1194450577",
    "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": "1701 N SENATE BLVD",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462021239",
            "telephone_number": "317-948-8657",
            "fax_number": "317-948-5949"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "555 S 18th St",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432052654",
            "country_code": "US",
            "telephone_number": "614-722-5423",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ZAYED",
        "first_name": "ELHAM",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-20",
        "last_updated": "2024-10-11",
        "certification_date": "2024-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207NP0225X",
            "taxonomy_group": "",
            "desc": "Dermatology, Pediatric Dermatology",
            "state": "OH",
            "license": "57253800",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "IN",
            "license": "01094652A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM PTAN",
            "identifier": "1104407961",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ezayed@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.