Individual provider Active NPI

Brian W Haag, MD

  • Surgery Physician
  • Indianapolis, IN
National Provider Identifier
1396781357
Registry record updated May 4, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
01028599A Issued in IN
Practice address
6620 Parkdale PL
Suite N
Indianapolis, IN 46254-5620
Phone
(317) 244-7160
Fax
(317) 244-7166
NPI assigned
Jun 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 4, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 01028599A IN Primary

Addresses

Primary practice location

6620 Parkdale PL
Suite N
Indianapolis, IN 46254-5620

Mailing address

6620 Parkdale PL
Suite N
Indianapolis, IN 46254-5620
Phone (317) 244-7160

Other identifiers 3

IdentifierTypeStateIssuer
020010156OtherMEDICARE RAIL ROAD
100189930MedicaidIN
020039695OtherINMEDICARE RAIL ROAD (IU HEALTH)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01028599AINMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Indiana University Health Care Associates, Inc Past Accepting new patients
Center for Surgical Sciences & Trauma, Inc Surgery Past Accepting new patients
Major Hospital Past Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1150761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1430697600000",
    "number": "1396781357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6620 PARKDALE PL",
            "address_2": "SUITE N",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462545620",
            "telephone_number": "317-244-7160",
            "fax_number": "317-244-7166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6620 PARKDALE PL",
            "address_2": "SUITE N",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462545620",
            "telephone_number": "317-244-7160",
            "fax_number": "317-244-7166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAAG",
        "first_name": "BRIAN",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-20",
        "last_updated": "2015-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IN",
            "license": "01028599A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAIL ROAD",
            "identifier": "020010156",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100189930",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAIL ROAD (IU HEALTH)",
            "identifier": "020039695",
            "state": "IN"
        }
    ],
    "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 May 4, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.