Terry Allen Iwasko, D.O.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

02001352 Issued in IN

Practice address

1011 Main St Ste 110
Indianapolis, IN 46224-6978

Phone

(317) 957-9150

Fax

(317) 957-9965

NPI assigned

Oct 11, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Electronic endpoints 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: tiwasko63132@ecommunitydirect.com

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.

• Community Physicians of Indiana Inc

  • Family Medicine Physician
  • Indianapolis, IN
  • NPI 1619105244

  Internal Medicine

  Medicare reassignment NPD
• Community Physicians of Indiana Inc

  • Endocrinology, Diabetes & Metabolism Physician
  • Carmel, IN
  • NPI 1992396337
  NPD
• Major Hospital

  • General Acute Care Hospital
  • Shelbyville, IN
  • NPI 1174555692
  NPD (past)
• Westview Internal Medicine

  • Internal Medicine Physician
  • Indianapolis, IN
  • NPI 1619092186
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650240000000",
    "number": "1295823631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6626 E 75TH ST",
            "address_2": "STE 500",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462502805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1011 MAIN ST STE 110",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462246978",
            "telephone_number": "317-957-9150",
            "fax_number": "317-957-9965"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5471 Georgetown Rd",
            "address_2": "Ste B",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462545793",
            "country_code": "US",
            "telephone_number": "317-644-3058",
            "fax_number": "317-388-1527",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "IWASKO",
        "first_name": "TERRY",
        "middle_name": "ALLEN",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-11",
        "last_updated": "2022-04-18",
        "certification_date": "2022-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IN",
            "license": "02001352",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100360790",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD PTAN",
            "identifier": "P01424409",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "000000793981",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tiwasko63132@eCommunityDirect.com",
            "affiliation": "Y",
            "affiliationName": "Community Physicians of Indiana Inc",
            "address_1": "7240 Shadeland Station",
            "address_2": "Suite 300",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "462563944",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Suzanne Ivkovich, N.P.
• Jaquille B Ivory
• Jasmine Dannielle Ivory, MD
• Ivx Health of Indiana PC
• Ivy Health Associates
• Meera Farzana Iyengar
• Boluwaji Iyiola
• Austin Ikechukwu Azubueke Izah
• J & J Pediatric Therapies LLC
• J & K'S Prompt Transportation

• Internal Medicine Physician in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Internal Medicine Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2022; 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.

Verify at the official NPI Registry.