Lars Optimus Logdberg, M.D.

Primary specialty

Emergency Medical Services (Emergency Medicine) PhysicianTaxonomy code 207PE0004X

License

01079959A Issued in IN

Practice address

1111 Ronald Reagan Pkwy
Avon, IN 46123-7085

Phone

(317) 217-3500

Fax

(317) 217-3115

NPI assigned

Apr 8, 2014

Last updated

Jun 14, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

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

Emergency Medicine

Education

Albert Einstein College of Medicine of Yeshiva University, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Hendricks County HospitalGroup PAC ID 4880505528, 341 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Hendricks Regional Health Hospital, Danville, IN, CCN 150005

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://sehproxy.stelizabeth.com/arr-fhir/api/FHIR/R4
• Direct secure messaging: llogdberg353546@direct-prd.stelizabeth.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Hendricks County Hospital

  dba HRH Associate Health

  • General Practice Physician
  • Danville, IN
  • NPI 1497536163
  Medicare reassignment Care Compare group NPD
• Indiana University Health Care Associates, Inc

  dba IU Health Physicians

  • General Practice Physician
  • Indianapolis, IN
  • NPI 1902032832
  Medicare reassignment NPD
• Hendricks County Hospital

  dba Hendricks Regional Health Immediate Care

  • Urgent Care Clinic/Center
  • Avon, IN
  • NPI 1063411551
  NPD
• Hendricks County Hospital

  dba Hendricks Pediatrics of Brownsburg

  • Pediatrics Physician
  • Brownsburg, IN
  • NPI 1508758210
  NPD

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

• Hendricks County Hospital

  • General Acute Care Hospital
  • Danville, IN
  • NPI 1669475950
  Care Compare affiliation

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

{
    "created_epoch": "1396915200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623628800000",
    "number": "1417376369",
    "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": "1111 RONALD REAGAN PKWY",
            "city": "AVON",
            "state": "IN",
            "postal_code": "461237085",
            "telephone_number": "317-217-3500",
            "fax_number": "317-217-3115"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "27005 76th Ave",
            "address_purpose": "LOCATION",
            "city": "New Hyde Park",
            "state": "NY",
            "postal_code": "110401402",
            "country_code": "US",
            "telephone_number": "718-470-7873",
            "fax_number": "718-470-9113",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8244 E US Highway 36 Ste 1100",
            "address_purpose": "LOCATION",
            "city": "Avon",
            "state": "IN",
            "postal_code": "461239627",
            "country_code": "US",
            "telephone_number": "317-272-7500",
            "fax_number": "317-272-7515",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LOGDBERG",
        "first_name": "LARS",
        "middle_name": "OPTIMUS",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-08",
        "last_updated": "2021-06-14",
        "certification_date": "2021-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "IN",
            "license": "01079959A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "llogdberg@direct.iuhealth.org",
            "affiliation": "N",
            "address_1": "1111 Ronald Reagan Pkwy",
            "city": "Avon",
            "state": "IN",
            "country_code": "US",
            "postal_code": "461237085",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Life Enrichment Counseling
• Ayo Beatrice Lincoln
• Linda Lewis Lister, M.D.
• Gloria Renee Littleton, FNP
• Ann Drayton Logan, MD
• Tayyebeh Loghmani, RD
• James Lone, RPH
• Allyson Nicole Long, PHARMD
• Marian L Longo, O.D.
• Krista L Lorenz, FNP

• Emergency Medical Services (Emergency Medicine) Physician in Avon, IN
• Providers in Avon, IN by specialty
• Emergency Medical Services (Emergency Medicine) Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2021; 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.