Kevin M Sheridan, MD

Primary specialty

Vascular Surgery PhysicianTaxonomy code 2086S0129X

License

01064638A Issued in IN

Practice address

8433 Harcourt Rd Ste 100
Indianapolis, IN 46260-2193

Phone

(317) 583-7600

NPI assigned

May 27, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 2

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

Specialty

Vascular SurgeryAlso: General Surgery

Education

University of Toledo College of Medicine, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

St Vincent Medical Group IncGroup PAC ID 7012047640, 728 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ascension St Vincent Hospital Hospital, Indianapolis, IN, CCN 150084
• St Vincent Heart Center Hospital, Carmel, IN, CCN 150153
• Witham Health Services Hospital, Lebanon, IN, CCN 150104
• Franciscan Health Crawfordsville Hospital, Crawfordsville, IN, CCN 150022
• Ascension St Vincent Carmel Hospital, Carmel, IN, CCN 150157

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ksheridan416326@reidhealth.direct-ci.com

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.

• St. Vincent Medical Group, Inc.

  • Orthopaedic Surgery Physician
  • Winchester, IN
  • NPI 1144513375

  Vascular Surgery

  Medicare reassignment Care Compare group NPD
• Major Hospital

  • General Acute Care Hospital
  • Shelbyville, IN
  • NPI 1174555692
  NPD (past)
• St Vincent Medical Group Inc

  • Cardiovascular Disease Physician
  • Indianapolis, IN
  • NPI 1558686436
  NPD (past)
• The Care Labs, LLC

  • Vascular & Interventional Radiology Physician
  • Indianapolis, IN
  • NPI 1215978523
  NPD (past)

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

• Franciscan Health Crawfordsville

  • General Acute Care Hospital
  • Crawfordsville, IN
  • NPI 1588774558
  Care Compare affiliation
• St. Clare Medical Center

  • Skilled Nursing Facility
  • Crawfordsville, IN
  • NPI 1508960535

  Hospital

  Care Compare affiliation
• St. Vincent Carmel Hospital, Inc.

  • General Acute Care Hospital
  • Carmel, IN
  • NPI 1639124134
  Care Compare affiliation
• St. Vincent Heart Center of Indiana, LLC

  • Special Hospital
  • Carmel, IN
  • NPI 1982681748
  Care Compare affiliation
• St. Vincent Hospital & Health Care Center, Inc.

  • General Acute Care Hospital
  • Indianapolis, IN
  • NPI 1306898960
  Care Compare affiliation
• St. Vincent Hospital & Health Care Center, Inc.

  • General Acute Care Hospital
  • Avon, IN
  • NPI 1851833230
  Care Compare affiliation
• Witham Memorial Hospital

  • General Acute Care Hospital
  • Lebanon, IN
  • NPI 1699757401
  Care Compare affiliation

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

{
    "created_epoch": "1211846400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660608000000",
    "number": "1407014426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8433 HARCOURT RD STE 100",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462602193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8433 HARCOURT RD STE 100",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462602193",
            "telephone_number": "317-583-7600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHERIDAN",
        "first_name": "KEVIN",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-05-27",
        "last_updated": "2022-08-16",
        "certification_date": "2022-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "IN",
            "license": "01064638A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200947160",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ksheridan416326@ReidHealth.direct-ci.com",
            "affiliation": "Y",
            "affiliationName": "Reid Physician Associates, Inc.",
            "address_1": "1100 Reid Pkwy",
            "city": "Richmond",
            "state": "IN",
            "country_code": "US",
            "postal_code": "473741157",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kevin.sheridan.1@7598.direct.athenahealth.com",
            "affiliation": "Y",
            "affiliationName": "St. Vincent Medical Group, Inc.",
            "address_1": "8433 Harcourt Rd Ste 100",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "462602193",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jeremy Sherer
• Mark Edwin Sherer, D.D.S.
• Richard Everett Sherer, D.D.S.
• Sarah Sherer
• Karsen Lee Sherfick, OD
• Krystin Chanelle Sheridan, ANP
• Stephanie N Sheridan
• Hend Sherif, DMD
• Jeanna Rochell Sheriff
• Mohamed Sheriff

• Vascular Surgery Physician in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Vascular Surgery Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2022; 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.

Verify at the official NPI Registry.