Individual provider Active NPI

Amy Marie Fruehwald, M.D.

  • Anesthesiology Physician
  • Indianapolis, IN
National Provider Identifier
1255622247
Registry record updated Jul 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
01084623B Issued in IN
Practice address
1402 E County Line Rd
Indianapolis, IN 46277-1447
Phone
(317) 887-7000
NPI assigned
Apr 25, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 036137418 IL
Student in an Organized Health Care Education/Training Program 390200000X
Anesthesiology Physician 207L00000X 01084623B IN Primary

Addresses

Primary practice location

1402 E County Line Rd
Indianapolis, IN 46277-1447

Mailing address

6626 E 75TH St Ste 500
Indianapolis, IN 46250-2890
Phone (317) 621-7912

Other practice location 1

5841 S Maryland Ave
Chicago, IL 60637-1447
Phone (773) 702-6842

Other identifiers 1

IdentifierTypeStateIssuer
Q00291745OtherINRAILROAD MEDICARE

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
I20200925001881 IN Practitioner - Anesthesiology 5698077337 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Northwestern University Feinberg Medical School, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Physicians of Indiana IncGroup PAC ID 1759416662, 1,569 clinicians

Practice addresses (Care Compare)

1402 E County Line Rd
Indianapolis, IN 46227-0963
Phone (317) 887-7113

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01084623BINMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southeast Anesthesiologists, Inc. Anesthesiology CurrentSince Nov 1, 2020 Accepting new patients
Community Physicians of Indiana Inc CurrentSince Apr 1, 2022 Accepting new patients
Community Physicians of Indiana Inc CurrentSince Apr 1, 2022 Accepting new patients

Locations

5819 Reliable Pkwy
Chicago, IL 60686

6626 E 75th St
Ste 500
Indianapolis, IN 46250
Phone (317) 621-7547

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

7120 Clearvista Dr
Ste 4000
Indianapolis, IN 46256
Phone (317) 621-7444

1402 E County Line Rd
Southport, IN 46227
Phone (317) 887-7000

Organizations & group practices 3

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.

Hospital & facility affiliations 1

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": "1303689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657843200000",
    "number": "1255622247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6626 E 75TH ST STE 500",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462502890",
            "telephone_number": "317-621-7912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1402 E COUNTY LINE RD",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462771447",
            "telephone_number": "317-887-7000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5841 S Maryland Ave",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606371447",
            "country_code": "US",
            "telephone_number": "773-702-6842",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FRUEHWALD",
        "first_name": "AMY",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-04-25",
        "last_updated": "2022-07-15",
        "certification_date": "2022-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IL",
            "license": "036137418",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IN",
            "license": "01084623B",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "Q00291745",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.