Individual provider Active NPI

Stacey Charles, MD

  • Family Medicine Physician
  • Indianapolis, IN
National Provider Identifier
1255940417
Registry record updated Sep 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
01090538A Issued in IN
Practice address
720 Eskenazi Ave FL 2
Indianapolis, IN 46202-5189
Phone
(317) 880-7000
NPI assigned
Jul 23, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 15, 2025

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 01090538A IN Primary

Addresses

Primary practice location

720 Eskenazi Ave FL 2
Indianapolis, IN 46202-5189

Mailing address

PO Box 637764
Cincinnati, OH 45263-7764
Phone (317) 880-3939

Other practice location 1

1040 Wishard Blvd
Indianapolis, IN 46202-2872
Phone (317) 962-8893

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address scharles76123@direct.eskenazihealth.edu

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
I20230809001162 IN Practitioner - Family Practice 8224453717 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Health and Hospital Corporation of Marion CountyGroup PAC ID 6709795974, 239 clinicians

Practice addresses (Care Compare)

720 Eskenazi Ave FL
2 Eskenazi Health Center
Indianapolis, IN 46202-5189
Phone (317) 880-7000

Hospital & facility affiliations

  • Eskenazi Health Hospital, Indianapolis, IN, CCN 150024

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
The Health and Hospital Corporation of Marion County Student in an Organized Health Care Education/Training Program CurrentSince Sep 18, 2023 Accepting new patients
The Health and Hospital Corporation of Marion County CurrentSince Sep 18, 2023 Accepting new patients

Locations

2732 W Michigan St
Indianapolis, IN 46222
Phone (317) 554-4600

1660 N Illinois St
Indianapolis, IN 46202
Phone (317) 880-2900

720 Eskenazi Ave
Fl 2
Indianapolis, IN 46202
Phone (317) 278-5316

720 Eskenazi Ave
Bldg 5TH
Indianapolis, IN 46202
Phone (317) 880-3818

5525 W 34th St
Indianapolis, IN 46224
Phone (317) 848-7368

2505 N Arlington Ave
Indianapolis, IN 46218
Phone (317) 554-5200

1112 Southeastern Ave
Indianapolis, IN 46202
Phone (317) 423-8909

2700 Martin Luther King Jr St
Indianapolis, IN 46208
Phone (317) 931-4300

5515 W 38th St
Indianapolis, IN 46254
Phone (317) 880-3838

9443 E 38th St
Indianapolis, IN 46235
Phone (317) 890-2100

6940 Michigan Rd
Ste 140
Indianapolis, IN 46268
Phone (317) 266-2901

3840 N Sherman Dr
Indianapolis, IN 46226
Phone (317) 541-3400

3010 N White River Parkway East Dr
Indianapolis, IN 46208
Phone (317) 880-3535

Interoperability endpoints

  • Direct secure messaging: scharles76123@direct.eskenazihealth.edu

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.

Hospital & facility affiliations 2

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": "1595462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757894400000",
    "number": "1255940417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 637764",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452637764",
            "telephone_number": "317-880-3939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 ESKENAZI AVE FL 2",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462025189",
            "telephone_number": "317-880-7000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1040 Wishard Blvd",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462022872",
            "country_code": "US",
            "telephone_number": "317-962-8893",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHARLES",
        "first_name": "STACEY",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-07-23",
        "last_updated": "2025-09-15",
        "certification_date": "2025-09-15",
        "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": "01090538A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "scharles76123@direct.eskenazihealth.edu",
            "affiliation": "N",
            "address_1": "720 Eskenazi Ave Fl 2",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "462025189",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.