Benjamin Scott Bacon, MD
Individual provider Active NPI Pediatrics Physician · Indianapolis, IN
NPI 1386263168 · NPPES record last updated May 9, 2025
Key facts
- NPI
- 1386263168
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatrics Physician 208000000X
- License
- 01090630A (IN)
- Practice address
- 705 Riley Hospital Dr
Indianapolis, IN 46202-5109 - Phone
- (317) 944-4034
- NPI assigned
- Apr 13, 2020
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 3
Medicare Care Compare profile
- Specialty
- Pediatric Medicine
- Education
- Indiana University School of Medicine, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Iu Health Medical Group LLC
Practice addresses (Care Compare)
1701 N Senate Ave
Indianapolis, IN 46202-5306
Phone (317) 962-2000
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230627001213 | IN | Practitioner - Pediatric Medicine | 8022430016 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01090630A | IN | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University Family Physicians, Inc. | Current |
Accepting new patients | |
| Iu Health Medical Group, LLC | Current |
Accepting new patients | |
| University Family Physicians, Inc. | Current |
Accepting new patients |
Locations
7216 Solutions Ctr
Chicago, IL 60677
1520 N Senate Ave
Indianapolis, IN 46202
Phone (317) 962-0857
2625 E 62nd St
Ste 2010
Indianapolis, IN 46220
Phone (317) 251-6121
250 N Shadeland Ave
Indianapolis, IN 46219
Phone (317) 948-9174
705 Riley Hospital Dr
Indianapolis, IN 46202
Phone (317) 274-4779
1701 Senate Blvd
Indianapolis, IN 46202
Phone (317) 612-2754
1701 N Senate Ave
Indianapolis, IN 46202
Phone (317) 929-8447
Interoperability endpoints
- bbacon@direct.iuhealth.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | IN | ||
| Pediatrics Physician | 208000000X | 01090630A | IN | Yes |
Addresses
Primary practice location
705 Riley Hospital Dr
Indianapolis, IN 46202-5109
Mailing address
705 Riley Hospital Dr
Indianapolis, IN 46202-5109
Other practice location 1
2625 E 62nd St Ste 2010
Indianapolis, IN 46220-0037
Phone (317) 251-6121
Other practice location 2
1701 N Senate Blvd
Indianapolis, IN 46202-1239
Phone (888) 484-3258
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 300039354 | Medicaid | IN | |
| 1103117458 | Other | IN | ANTHEM PTAN |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | bbacon@direct.iuhealth.org | Direct | |
| Direct Messaging Address | bbacon@direct.iuhealth.org | Direct |
Other providers in Indianapolis, IN
- Morgan Leah Backes
- Kevin M Backfish
- Sougandhi Backhaus
- Haydee Backing
- Doreen A Backus
- Gary Lee Bacon
- Starr Bacon
- Veronica Bacon
- Bacsa Dental PC
- Tim Bacsa
All providers in Indianapolis, IN · Pediatrics Physician in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 9, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.