Active NPI
Abdul Subhan, M.D.
- Psychiatry Physician
- Indianapolis, IN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 01065489A
- Practice address
- 2506 Willowbrook Pkwy Ste 102a
Indianapolis, IN 46205-1542 - Phone
- (317) 803-2270
- Fax
- (317) 217-1769
- NPI assigned
- Apr 16, 2008
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 49780-20 | WI | |
| Psychiatry Physician | 2084P0800X | 57.012438 | OH | |
| Psychiatry Physician | 2084P0800X | 01065489A | IN | Primary |
Addresses
Primary practice location
2506 Willowbrook Pkwy Ste 102a
Indianapolis, IN 46205-1542
Mailing address
240 N Tillotson Ave
Muncie, IN 47304-3988
Phone (765) 288-1928
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
Care Compare profile
Medicare Care Compare- Specialty
- Psychiatry
- Education
- Other, 1996
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
100 N Tillotson Ave
Muncie, IN 47304-3987
Phone (765) 288-1928
110 N Tillotson Ave
Muncie, IN 47304-3987
Phone (765) 288-1928
130 N Tillotson Ave
Muncie, IN 47304-3987
Phone (765) 288-1928
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 49780-20 | WI | MD | Family Medicine Physician |
| 01065489A | IN | MD | Psychiatry Physician |
| 57.012438 | OH | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Meridian Health Services Corp. | Current | Accepting new patients | |
| Meridian Health Services Corp | Current | Accepting new patients | |
| Indiana University Health Ball Memorial Physicians, Inc. | Psychiatry | Current | Accepting new patients |
| Indiana University Health Ball Memorial Physicians, Inc. | Family Medicine | Current | Accepting new patients |
Locations
3832 Solutions Ctr
Chicago, IL 60677
2506 Willowbrook Pkwy
Ste 102A
Indianapolis, IN 46205
Phone (317) 803-2270
240 N Tillotson Ave
Muncie, IN 47304
2401 W University Ave
Muncie, IN 47303
Phone (765) 747-3111
221 N Celia Ave
Muncie, IN 47303
Phone (765) 747-3141
130 N Tillotson Ave
Muncie, IN 47304
Phone (765) 288-3770
931 W Water St
Portland, IN 47371
Phone (260) 726-9348
Interoperability endpoints
- abdul.subhan.p1@direct.meridianhs.nextgenshare.com
Organizations & group practices 4
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.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Muncie, IN
- NPI 1992755490
-
- Family Medicine Physician
- Muncie, IN
- NPI 1235455544
-
- Internal Medicine Physician
- Muncie, IN
- NPI 1235152125
Psychiatry
-
- Federally Qualified Health Center (FQHC)
- Montpelier, IN
- NPI 1417838574
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- New Castle, IN
- NPI 1356428429
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1208304000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1580083200000",
"number": "1376717744",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "240 N TILLOTSON AVE",
"city": "MUNCIE",
"state": "IN",
"postal_code": "473043988",
"telephone_number": "765-288-1928",
"fax_number": "765-741-0335"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2506 WILLOWBROOK PKWY STE 102A",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462051542",
"telephone_number": "317-803-2270",
"fax_number": "317-217-1769"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SUBHAN",
"first_name": "ABDUL",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-04-16",
"last_updated": "2020-01-27",
"certification_date": "2020-01-27",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "WI",
"license": "49780-20",
"primary": false
},
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "OH",
"license": "57.012438",
"primary": false
},
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "IN",
"license": "01065489A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"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 Jan 27, 2020; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.