Individual provider Active NPI

Andres Fajardo, MD

  • Vascular Surgery Physician
  • Indianapolis, IN
National Provider Identifier
1447417829
Registry record updated Aug 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
01065981A Issued in IN
Practice address
1801 N Senate Blvd
MPC2 Suite 3500
Indianapolis, IN 46202-1228
Phone
(317) 962-0280
NPI assigned
May 22, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery Physician 2086S0129X 01065981A IN Primary

Addresses

Primary practice location

1801 N Senate Blvd
MPC2 Suite 3500
Indianapolis, IN 46202-1228

Mailing address

250 N Shadeland Ave
Indianapolis, IN 46219-4959

Other practice location 1

2651 E Discovery Pkwy
Bloomington, IN 47408-9059
Phone (812) 355-6900

Other identifiers 4

IdentifierTypeStateIssuer
200980740MedicaidIN
815500263OtherINMEDICARE PTAN
P00911441OtherINRAILROAD PTAN
M400018709OtherINMEDICARE PTAN

Other names 1

  • Dr. Andres Fajardo Carbonell Other name

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address afajardo@direct.iuhealth.org
Direct Messaging Address afajardo@direct.iuhealth.org Direct

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
I20100726000737 IN Practitioner - Vascular Surgery 2961535067 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Vascular Surgery
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Iu Health Medical Group LLCGroup PAC ID 9638617913, 4,382 clinicians
University Vascular Surgery, IncGroup PAC ID 7911969050, 16 clinicians

Practice addresses (Care Compare)

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

1801 N Senate Blvd
Indianapolis, IN 46202-1184
Phone (317) 962-0280

Hospital & facility affiliations

  • Eskenazi Health Hospital, Indianapolis, IN, CCN 150024
  • Indiana University Health Hospital, Indianapolis, IN, CCN 150056
  • Parkview Regional Medical Center Hospital, Fort Wayne, IN, CCN 150021
  • Reid Health Hospital, Richmond, IN, CCN 150048
  • Memorial Hospital and Health Care Center Hospital, Jasper, IN, CCN 150115

Procedures performed for Medicare patients

ProcedureNumber of procedures
Leg revascularization (restoring blood flow)1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Iu Health Medical Group, LLC CurrentSince Jan 1, 2026 Accepting new patients
Indiana University Health Southern Indiana Physicians, LLC CurrentSince Aug 4, 2023 Accepting new patients
Arnett Clinic, LLC Current Accepting new patients
Arnett Clinic, LLC CurrentSince Jul 1, 2018 Accepting new patients
Indiana University Health Southern Indiana Physicians LLC CurrentSince Aug 4, 2023 Accepting new patients
University Vascular Surgery, Inc Vascular Surgery CurrentSince May 5, 2010 Accepting new patients
Arnett Clinic, LLC CurrentSince Jul 1, 2018 Accepting new patients
Major Hospital Past Accepting new patients

Locations

8016 Reliable Pkwy
Chicago, IL 60686

2651 E Discovery Pkwy
Bloomington, IN 47408
Phone (812) 353-9147

727 W 2nd St
Bloomington, IN 47403
Phone (812) 353-3450

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

250 N Shadeland Ave
Indianapolis, IN 46219
Phone (317) 948-9174

1801 N Senate Blvd
Ste 3300
Indianapolis, IN 46202
Phone (317) 948-0944

1801 Senate Blvd
Indianapolis, IN 46202
Phone (317) 929-8880

1801 Senate Blvd
Ste 3500
Indianapolis, IN 46202
Phone (317) 274-7827

1481 W 10th St
#C1027
Indianapolis, IN 46202

2600 Greenbush St
Lafayette, IN 47904

Interoperability endpoints

  • Direct secure messaging: afajardo15588@direct.eskenazihealth.edu
  • Direct secure messaging: afajardo@direct.iuhealth.org

Organizations & group practices 8

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 6

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": "1211414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691539200000",
    "number": "1447417829",
    "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": "1801 N SENATE BLVD",
            "address_2": "MPC2 SUITE 3500",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462021228",
            "telephone_number": "317-962-0280"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2651 E Discovery Pkwy",
            "address_purpose": "LOCATION",
            "city": "Bloomington",
            "state": "IN",
            "postal_code": "474089059",
            "country_code": "US",
            "telephone_number": "812-355-6900",
            "fax_number": "812-339-1292",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FAJARDO",
        "first_name": "ANDRES",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-05-22",
        "last_updated": "2023-08-09",
        "certification_date": "2023-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "IN",
            "license": "01065981A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200980740",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "815500263",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD PTAN",
            "identifier": "P00911441",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "M400018709",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "afajardo@direct.iuhealth.org",
            "affiliation": "N",
            "address_1": "1801 N Senate Blvd",
            "address_2": "MPC2 Suite 3500",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "462021228",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "afajardo@direct.iuhealth.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2651 E Discovery Pkwy",
            "city": "Bloomington",
            "state": "IN",
            "country_code": "US",
            "postal_code": "474089059",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "ANDRES",
            "last_name": "FAJARDO CARBONELL",
            "prefix": "DR.",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.