Individual provider Active NPI

Thomas M Brogan, MD

  • Family Medicine Physician
  • Indianapolis, IN
National Provider Identifier
1316911894
Registry record updated Mar 30, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
01022653A Issued in IN
Practice address
8424 Naab Rd
Ste. 1C
Indianapolis, IN 46260-5918
Phone
(317) 875-7221
Fax
(317) 879-8063
NPI assigned
Feb 14, 2006
Last updated
Mar 30, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 01022653A IN Primary

Addresses

Primary practice location

8424 Naab Rd
Ste. 1C
Indianapolis, IN 46260-5918

Mailing address

10601 E 106TH St
Ste. 1C
Fishers, IN 46037-8270
Phone (317) 849-9297

Other identifiers 1

IdentifierTypeStateIssuer
100047380MedicaidIN

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
I20160406000927 IN Order and Referring Only - Family PracticePractitioner - Family Practice 1850363938

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Major Hospital Past Accepting new patients
Care Group LLC Family Medicine Past Accepting new patients

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, 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": "1139875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459296000000",
    "number": "1316911894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10601 E 106TH ST",
            "address_2": "STE. 1C",
            "city": "FISHERS",
            "state": "IN",
            "postal_code": "460378270",
            "telephone_number": "317-849-9297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8424 NAAB RD",
            "address_2": "STE. 1C",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462605918",
            "telephone_number": "317-875-7221",
            "fax_number": "317-879-8063"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROGAN",
        "first_name": "THOMAS",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-14",
        "last_updated": "2016-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01022653A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100047380",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.