Individual provider Active NPI

Andrew J Brougher, M.D.

  • Family Medicine Physician
  • Indianapolis, IN
National Provider Identifier
1255862967
Registry record updated Jun 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
01084840A Issued in IN
Practice address
10122 E 10TH St Ste 100
Indianapolis, IN 46229-2697
Phone
(317) 355-3717
NPI assigned
Mar 23, 2017
Last updated
Jun 8, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2021

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
Family Medicine Physician 207Q00000X 01084840A IN Primary

Addresses

Primary practice location

10122 E 10TH St Ste 100
Indianapolis, IN 46229-2697

Mailing address

6626 E 75TH St Ste 500
Indianapolis, IN 46250-2890

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
I20201201001648 IN Practitioner - Family Practice 7517378250 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Indiana University School of Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Physicians of Indiana IncGroup PAC ID 1759416662, 1,569 clinicians
Jane Pauley Community Health Center IncGroup PAC ID 7618152729, 77 clinicians

Practice addresses (Care Compare)

10122 E 10TH St
Suite 100
Indianapolis, IN 46229-2697
Phone (317) 355-5717

2040 N Shadeland Ave
Suite 300
Indianapolis, IN 46219-1712
Phone (463) 209-8503

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Community Physicians of Indiana Inc Family Medicine CurrentSince Dec 14, 2020 Accepting new patients
Community Physicians of Indiana Inc CurrentSince Dec 14, 2020 Accepting new patients
Major Hospital Past Accepting new patients

Locations

5819 Reliable Pkwy
Chicago, IL 60686

10122 E 10th St
Ste 100
Indianapolis, IN 46229
Phone (317) 355-5717

2040 N Shadeland Ave
Ste 300
Indianapolis, IN 46219
Phone (317) 355-3232

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

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

Organizations & group practices 4

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": "1490227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623110400000",
    "number": "1255862967",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10122 E 10TH ST STE 100",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462292697",
            "telephone_number": "317-355-3717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROUGHER",
        "first_name": "ANDREW",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-03-23",
        "last_updated": "2021-06-08",
        "certification_date": "2021-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01084840A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.