Individual provider Active NPI

Kellie H McDonald, M.D.

  • Diagnostic Radiology Physician
  • Indianapolis, IN
National Provider Identifier
1407886047
Registry record updated Feb 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
01061770A Issued in IN
Practice address
1701 N Senate Ave
Room 1204a
Indianapolis, IN 46202-1239
Phone
(317) 962-6793
Fax
(317) 962-8281
NPI assigned
Jul 3, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 01061770A IN Primary

Addresses

Primary practice location

1701 N Senate Ave
Room 1204a
Indianapolis, IN 46202-1239

Mailing address

250 N Shadeland Avenue
Suite 130
Indianapolis, IN 46219-4959
Phone (317) 963-0860

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kmcdona1@direct.iuhealth.org

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
I20061219000023 IN Practitioner - Diagnostic Radiology 6709885841 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Indiana University School of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Indiana University Radiology Associates IncGroup PAC ID 7315922267, 213 clinicians
Iu Health Medical Group LLCGroup PAC ID 9638617913, 4,382 clinicians

Practice addresses (Care Compare)

1001 W 10TH St
Indianapolis, IN 46202-2859
Phone (317) 630-7382

1701 N Senate Blvd
Indianapolis, IN 46202-1239
Phone (888) 484-3258

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01061770AINMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Indiana University Radiology Associates, Inc. Diagnostic Radiology CurrentSince Aug 16, 2009 Accepting new patients
Iu Health Medical Group, LLC CurrentSince Oct 1, 2025 Accepting new patients
Indiana Radiology Partners, Inc Diagnostic Radiology Past Accepting new patients

Locations

5924 Reliable Pkwy
Chicago, IL 60686

11725 Illinois St
Ste 355
Carmel, IN 46032
Phone (317) 814-4533

1001 W 10th St
Indianapolis, IN 46202
Phone (317) 630-6175

250 University Blvd
Indianapolis, IN 46202
Phone (317) 274-8580

250 N Shadeland Ave
Ste 130
Indianapolis, IN 46219
Phone (317) 962-4836

1701 N Senate Ave
Rm 1204A
Indianapolis, IN 46202
Phone (317) 962-6793

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

250 N Shadeland Ave
Ste 200
Indianapolis, IN 46219
Phone (317) 962-4836

1701 Senate Blvd
#C6
Indianapolis, IN 46202
Phone (317) 962-9000

1000 S Main St
Tipton, IN 46072
Phone (765) 675-8500

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.

Hospital & facility affiliations 5

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": "1151884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613174400000",
    "number": "1407886047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 N SHADELAND AVENUE",
            "address_2": "SUITE 130",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462194959",
            "telephone_number": "317-963-0860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 N SENATE AVE",
            "address_2": "ROOM 1204A",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462021239",
            "telephone_number": "317-962-6793",
            "fax_number": "317-962-8281"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDONALD",
        "first_name": "KELLIE",
        "middle_name": "H",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-03",
        "last_updated": "2021-02-13",
        "certification_date": "2021-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "IN",
            "license": "01061770A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kmcdona1@direct.iuhealth.org",
            "affiliation": "N",
            "address_1": "1701 N Senate Ave",
            "address_2": "Room 1204A",
            "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.