Individual provider Active NPI

Mark U Kyker, M.D.

  • Anesthesiology Physician
  • Indianapolis, IN
National Provider Identifier
1417917873
Registry record updated Nov 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
01040585 Issued in IN
Practice address
8040 Clearvista Pkwy
Indianapolis, IN 46256-5630
Phone
(317) 567-2179
Fax
(317) 567-2191
NPI assigned
Mar 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 01040585 IN Primary

Addresses

Primary practice location

8040 Clearvista Pkwy
Indianapolis, IN 46256-5630

Mailing address

PO Box 6005
Dept 196
Indianapolis, IN 46206-6005
Phone (317) 567-2180

Other identifiers 1

IdentifierTypeStateIssuer
100378660MedicaidIN

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
I20050523000961 IN Practitioner - Anesthesiology 9234031592 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
University of Kentucky College of Medicine, 1990
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)

10580 N Meridian St
Carmel, IN 46290-1028
Phone (317) 583-5000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01040585INMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St. Vincent Medical Group, Inc. Anesthesiology CurrentSince Aug 6, 2012 Accepting new patients

Locations

10580 N Meridian St
Carmel, IN 46290
Phone (317) 338-2273

2001 W 86th St
Indianapolis, IN 46260
Phone (317) 338-3617

8433 Harcourt Rd
Ste 100
Indianapolis, IN 46260
Phone (317) 583-7702

Organizations & group practices 1

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 3

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": "1143504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1225670400000",
    "number": "1417917873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6005",
            "address_2": "DEPT 196",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462066005",
            "telephone_number": "317-567-2180",
            "fax_number": "317-567-2191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8040 CLEARVISTA PKWY",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462565630",
            "telephone_number": "317-567-2179",
            "fax_number": "317-567-2191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KYKER",
        "first_name": "MARK",
        "middle_name": "U",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-28",
        "last_updated": "2008-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IN",
            "license": "01040585",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100378660",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.