Individual provider Active NPI

Jie Xie, MD

  • Pain Medicine (Anesthesiology) Physician
  • Indianapolis, IN
National Provider Identifier
1376923359
Registry record updated Nov 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
License
01083484A Issued in IN
Practice address
1701 N Senate Blvd
Indianapolis, IN 46202-1239
Phone
(317) 274-0275
Fax
(317) 274-0256
NPI assigned
Jun 4, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 01083484A IN
Pain Medicine (Anesthesiology) Physician 207LP2900X 036.156337 IL
Student in an Organized Health Care Education/Training Program 390200000X 11020054A IN
Pain Medicine (Anesthesiology) Physician 207LP2900X 01083484A IN Primary

Addresses

Primary practice location

1701 N Senate Blvd
Indianapolis, IN 46202-1239

Mailing address

250 N Shadeland Ave
Indianapolis, IN 46219-4959

Other practice location 1

2160 S 1st Ave
Maywood, IL 60153-3328
Phone (708) 216-9169

Other practice location 2

550 University Blvd
Indianapolis, IN 46202-5149
Phone (317) 274-0275

Other identifiers 2

IdentifierTypeStateIssuer
300062008MedicaidIN
1102233913OtherINANTHEM PTAN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jxie@direct.iuhealth.org Direct

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
I20220524002044 IN Practitioner - Pain ManagementPractitioner - Anesthesiology 6204147838 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pain ManagementAlso: Anesthesiology
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northside Anesthesia Services, LLCGroup PAC ID 7719891027, 94 clinicians

Practice addresses (Care Compare)

2001 W 86TH St
Indianapolis, IN 46260-1902
Phone (317) 338-2345

Hospital & facility affiliations

  • Ascension St Vincent Hospital Hospital, Indianapolis, IN, CCN 150084
  • Ascension St Vincent Fishers Hospital, Fishers, IN, CCN 150181

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036.156337ILMDPain Medicine (Anesthesiology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Iu Anesthesiology Associates, LLC Anesthesiology CurrentSince Feb 1, 2023 Accepting new patients
Iu Health Medical Group, LLC CurrentSince Jan 1, 2025 Accepting new patients
Loyola University Medical Center Current Accepting new patients

Locations

2160 S 1st Ave
Bldg 103
Maywood, IL 60153
Phone (708) 216-6462

2160 S 1st Ave
Maywood, IL 60153
Phone (708) 216-4400

1130 W Michigan St
Indianapolis, IN 46202
Phone (317) 274-0076

1701 Senate Blvd
Indianapolis, IN 46202
Phone (317) 612-2754

1130 W Michigan St
#204
Indianapolis, IN 46202
Phone (317) 274-0076

550 University Blvd
Indianapolis, IN 46202
Phone (217) 274-5000

250 N Shadeland Ave
Indianapolis, IN 46219
Phone (317) 948-9174

550 University Blvd
#2180
Indianapolis, IN 46202
Phone (317) 274-2891

250 N Shadeland Ave
Rm 3107
Indianapolis, IN 46219

2001 W 86th St
Indianapolis, IN 46260
Phone (317) 338-3617

Interoperability endpoints

  • Direct secure messaging: jxie139957@direct.luhs.org

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 3

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": "1433376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732147200000",
    "number": "1376923359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 N SHADELAND AVE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462194959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 N SENATE BLVD",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462021239",
            "telephone_number": "317-274-0275",
            "fax_number": "317-274-0256"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2160 S 1st Ave",
            "address_purpose": "LOCATION",
            "city": "Maywood",
            "state": "IL",
            "postal_code": "601533328",
            "country_code": "US",
            "telephone_number": "708-216-9169",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "550 University Blvd",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462025149",
            "country_code": "US",
            "telephone_number": "317-274-0275",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "XIE",
        "first_name": "JIE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-04",
        "last_updated": "2024-11-21",
        "certification_date": "2024-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IN",
            "license": "01083484A",
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "IL",
            "license": "036.156337",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "IN",
            "license": "11020054A",
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "IN",
            "license": "01083484A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300062008",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM PTAN",
            "identifier": "1102233913",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jxie@direct.iuhealth.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1701 N Senate Blvd",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "462021239",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.