Individual provider Active NPI

Michael D Pisano, PHD

  • Psychologist
  • Indianapolis, IN
National Provider Identifier
1336187103
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
20010381 Issued in IN
Practice address
2601 Cold Spring Rd
Indianapolis, IN 46222-2202
Phone
(317) 274-3960
NPI assigned
Jun 3, 2006
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 20010381 IN Primary

Addresses

Primary practice location

2601 Cold Spring Rd
Indianapolis, IN 46222-2202

Mailing address

550 N Meridian St
Ste 114
Indianapolis, IN 46204-1207

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
I20031106000162 IN Practitioner - Clinical Psychologist 6406769546 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mending Minds, LLCGroup PAC ID 4284037987, 15 clinicians

Practice addresses (Care Compare)

1311 W 96TH St
Suite 110
Indianapolis, IN 46260-1172
Phone (317) 876-3699

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20010381INMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Mending Minds, LLC CurrentSince Oct 25, 2021 Accepting new patients
Indiana University Psychiatric Associates, Inc. Psychologist PastSince Dec 18, 2003 Accepting new patients

Locations

1311 W 96th St
Indianapolis, IN 46260
Phone (317) 876-3699

1311 W 96th St
Ste 110
Indianapolis, IN 46260
Phone (317) 296-7707

3900 Southland Ave
Kokomo, IN 46902
Phone (317) 876-3699

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/24167/brand/1/csg/1/fhir/r4

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": "1149292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1336187103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 N MERIDIAN ST",
            "address_2": "STE 114",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462041207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2601 COLD SPRING RD",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462222202",
            "telephone_number": "317-274-3960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PISANO",
        "first_name": "MICHAEL",
        "middle_name": "D",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-03",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "IN",
            "license": "20010381",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.