Individual provider Active NPI

Mohanjit Gill, M.D.

  • Pediatrics Physician
  • Kokomo, IN
National Provider Identifier
1447245014
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
01045214 Issued in IN
Practice address
3506 S Lafountain St
Kokomo, IN 46902-3803
Phone
(765) 864-6700
Fax
(765) 864-6703
NPI assigned
Sep 20, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 01045214 IN Primary

Addresses

Primary practice location

3506 S Lafountain St
Kokomo, IN 46902-3803

Mailing address

6626 E 75TH St
Suite 500
Indianapolis, IN 46250-2890

Other identifiers 1

IdentifierTypeStateIssuer
200106330MedicaidIN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mgill126173@eCommunityDirect.com Community Physicians of Indiana Inc

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
I20140110000746 IN Practitioner - Pediatric Medicine 2062640485 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01045214INMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Jane Pauley Community Health Center Inc CurrentSince Jan 14, 2025 Accepting new patients
Community Physicians of Indiana Inc Pediatrics CurrentSince Jan 1, 2017 Accepting new patients
Community Physicians of Indiana Inc CurrentSince Jan 1, 2017 Accepting new patients

Locations

5819 Reliable Pkwy
Chicago, IL 60686

7120 Clearvista Dr
Ste 4000
Indianapolis, IN 46256
Phone (317) 621-7444

6626 E 75th St
Ste 500
Indianapolis, IN 46250
Phone (317) 621-7547

8931 E 30th St
Indianapolis, IN 46219
Phone (317) 355-9320

1503 N Mitthoefer Rd
Indianapolis, IN 46229

3611 S Reed Rd
Kokomo, IN 46902
Phone (765) 400-2915

3510 S Lafountain St
Kokomo, IN 46902
Phone (765) 864-5760

3500 S Lafountain St
Kokomo, IN 46902
Phone (765) 453-0702

3506 S Lafountain St
Kokomo, IN 46902
Phone (765) 864-6700

Interoperability endpoints

  • Direct secure messaging: mgill746494@direct.ochin.org
  • Direct secure messaging: mgill126173@ecommunitydirect.com

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": "1127174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1447245014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6626 E 75TH ST",
            "address_2": "SUITE 500",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462502890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3506 S LAFOUNTAIN ST",
            "city": "KOKOMO",
            "state": "IN",
            "postal_code": "469023803",
            "telephone_number": "765-864-6700",
            "fax_number": "765-864-6703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILL",
        "first_name": "MOHANJIT",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-20",
        "last_updated": "2023-11-27",
        "certification_date": "2020-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IN",
            "license": "01045214",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200106330",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mgill126173@eCommunityDirect.com",
            "affiliation": "Y",
            "affiliationName": "Community Physicians of Indiana Inc",
            "address_1": "3506 S Lafountain St",
            "city": "Kokomo",
            "state": "IN",
            "country_code": "US",
            "postal_code": "469023803",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Kokomo, IN

Sources for this page

Verify at the official NPI Registry.