Individual provider Active NPI

Nour Elsheikh

  • Clinical Psychologist
  • Carmel, IN
National Provider Identifier
1295584662
Registry record updated May 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
20043786B Issued in IN
Practice address
201 Pennsylvania Pkwy Ste 200
Carmel, IN 46280-1393
Phone
(317) 805-5500
Fax
(317) 805-5501
NPI assigned
May 16, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 16, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 20043786B IN Primary

Addresses

Primary practice location

201 Pennsylvania Pkwy Ste 200
Carmel, IN 46280-1393

Mailing address

201 Pennsylvania Pkwy Ste 200
Carmel, IN 46280-1393
Phone (317) 805-5500

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240612002979 IN Practitioner - Clinical Psychologist 8123560539 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Indiana Polyclinic PCGroup PAC ID 6608016019, 6 clinicians

Practice addresses (Care Compare)

201 Pennsylvania Pkwy
Suite 200
Carmel, IN 46280-1393
Phone (317) 805-5500

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
20043786BINMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Indiana Polyclinic PC CurrentSince Jun 1, 2024 Accepting new patients

Locations

201 Pennsylvania Pkwy
Ste 200
Carmel, IN 46280
Phone (317) 805-5500

Organizations & group practices 1

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": "1715817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715817600000",
    "number": "1295584662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 PENNSYLVANIA PKWY STE 200",
            "city": "CARMEL",
            "state": "IN",
            "postal_code": "462801393",
            "telephone_number": "317-805-5500",
            "fax_number": "317-805-5501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 PENNSYLVANIA PKWY STE 200",
            "city": "CARMEL",
            "state": "IN",
            "postal_code": "462801393",
            "telephone_number": "317-805-5500",
            "fax_number": "317-805-5501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELSHEIKH",
        "first_name": "NOUR",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-05-16",
        "last_updated": "2024-05-16",
        "certification_date": "2024-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IN",
            "license": "20043786B",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carmel, IN

Sources for this page

Verify at the official NPI Registry.