Active NPI
Mary Verghese, MD
- Pediatrics Physician
- Indianapolis, IN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 01059018A
- Practice address
- 705 Riley Hospital Dr
Indianapolis, IN 46202-5109 - Phone
- (317) 944-3636
- Fax
- (317) 948-5844
- NPI assigned
- Jul 10, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 01059018A | IN | |
| Pediatric Emergency Medicine (Pediatrics) Physician | 2080P0204X | 01059018 | IN | |
| Pediatrics Physician | 208000000X | 01059018A | IN | Primary |
Addresses
Primary practice location
705 Riley Hospital Dr
Indianapolis, IN 46202-5109
Mailing address
250 N Shadeland Ave
Indianapolis, IN 46219-4959
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200481970 | Medicaid | IN | |
| 000000741646 | Other | IN | ANTHEM PIN |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | mverghes@direct.iuhealth.org |
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01059018A | IN | MD | Emergency Medicine Physician |
| 01059018 | IN | MD | Pediatric Emergency Medicine (Pediatrics) Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Indiana University Health Care Associates, Inc | Current | Accepting new patients | |
| Iu Health Medical Group, LLC | Current | Accepting new patients | |
| Iu Health Medical Group Riley Specialists, LLC | Pediatrics | Current | Accepting new patients |
| Indiana Clinic Critical Care LLC | Current | Accepting new patients | |
| Icem-University-Riley, LLC | Emergency Medicine | Past | Accepting new patients |
| Emgi - Riley, LLC | Emergency Medicine | Past | Accepting new patients |
| University Medical Diagnostic Associates, Inc. | Past | Accepting new patients | |
| Emgi - University, LLC | Past | Accepting new patients |
Locations
5208 Reliable Pkwy
Chicago, IL 60686
2574 Reliable Pkwy
Chicago, IL 60686
702 Barnhill Dr
Indianapolis, IN 46202
Phone (317) 274-0273
1701 Senate Blvd
Indianapolis, IN 46202
Phone (317) 612-2754
1801 Senate Blvd
Ste 230
Indianapolis, IN 46202
Phone (317) 962-5280
705 Riley Hospital Dr
Indianapolis, IN 46202
Phone (317) 274-4779
250 N Shadeland Ave
Indianapolis, IN 46219
Phone (317) 948-9174
1701 N Senate Blvd
Bldg C6
Indianapolis, IN 46202
Phone (913) 962-2000
250 N Shadeland Ave
Ste 130
Indianapolis, IN 46219
Phone (317) 962-4836
Organizations & group practices 8
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.
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- General Practice Physician
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- NPI 1902032832
-
- Pediatrics Physician
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- NPI 1699561480
-
- General Practice Physician
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- NPI 1326893777
-
- Emergency Medicine Physician
- Indianapolis, IN
- NPI 1720020381
-
- Emergency Medical Services (Emergency Medicine) Physician
- Indianapolis, IN
- NPI 1508808783
-
- Emergency Medicine Physician
- Indianapolis, IN
- NPI 1417284563
-
- Internal Medicine Physician
- Indianapolis, IN
- NPI 1861441537
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152489600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1732147200000",
"number": "1265466908",
"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": "705 RILEY HOSPITAL DR",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462025109",
"telephone_number": "317-944-3636",
"fax_number": "317-948-5844"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VERGHESE",
"first_name": "MARY",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-10",
"last_updated": "2024-11-21",
"certification_date": "2024-11-21",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "IN",
"license": "01059018A",
"primary": false
},
{
"code": "2080P0204X",
"taxonomy_group": "",
"desc": "Pediatrics, Pediatric Emergency Medicine",
"state": "IN",
"license": "01059018",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "IN",
"license": "01059018A",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200481970",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM PIN",
"identifier": "000000741646",
"state": "IN"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "mverghes@direct.iuhealth.org",
"affiliation": "N",
"address_1": "705 Riley Hospital Dr",
"city": "Indianapolis",
"state": "IN",
"country_code": "US",
"postal_code": "462025109",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Indianapolis, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.