Individual provider Active NPI

Abdul Subhan, M.D.

  • Psychiatry Physician
  • Indianapolis, IN
National Provider Identifier
1376717744
Registry record updated Jan 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
01065489A Issued in IN
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

Updated by the provider on Jan 27, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091027000319 IN Practitioner - Psychiatry 1153468988 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Meridian Health Services CorpGroup PAC ID 5597679845, 78 clinicians

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

LicenseStateTypeSpecialty
49780-20WIMDFamily Medicine Physician
01065489AINMDPsychiatry Physician
57.012438OHMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Meridian Health Services Corp. CurrentSince May 31, 2011 Accepting new patients
Meridian Health Services Corp CurrentSince May 31, 2011 Accepting new patients
Indiana University Health Ball Memorial Physicians, Inc. Psychiatry CurrentSince Oct 1, 2011 Accepting new patients
Indiana University Health Ball Memorial Physicians, Inc. Family Medicine CurrentSince Oct 1, 2011 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

  • Direct secure messaging: 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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

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

Verify at the official NPI Registry.