Individual provider Active NPI

Raufu Adefemi Lasisi, MD

  • Hospitalist Physician
  • Indianapolis, IN
National Provider Identifier
1447419858
Registry record updated Mar 4, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
01067846A Issued in IN
Practice address
550 University Blvd
Indianapolis, IN 46202-5149
Phone
(317) 948-0762
NPI assigned
Jun 2, 2008
Last updated
Mar 4, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 11013709A IN
Hospitalist Physician 208M00000X 01067846A IN Primary

Addresses

Primary practice location

550 University Blvd
Indianapolis, IN 46202-5149

Mailing address

8910 Purdue Rd
Ste 500
Indianapolis, IN 46268-3161

Other identifiers 5

IdentifierTypeStateIssuer
200980210MedicaidIN
205110OtherHPN MEDICARE GROUP#
000000672592OtherHPN ANTHEM PIN#
000000708549OtherINANTHEM PROVIDER NUMBER / TIN 35-2030653
200311740HOtherINHPN MEDICAID GROUP#/LOCATION

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
I20100615000273 IN Practitioner - Internal Medicine 0244360428 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Iu Health Medical Group LLCGroup PAC ID 9638617913, 4,382 clinicians
Arnett Clinic LLCGroup PAC ID 0749184380, 401 clinicians

Practice addresses (Care Compare)

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

2600 Greenbush St
Lafayette, IN 47904-2477
Phone (765) 448-8000

5165 McCarty LN
Lafayette, IN 47905-8764
Phone (765) 448-8000

5177 McCarty LN
Lafayette, IN 47905-8764
Phone (765) 448-8000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11013709AINMDInternal Medicine Physician
01067846AINMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Arnett Clinic, LLC Internal Medicine CurrentSince Jul 5, 2011 Accepting new patients
Hospitalist Physicians of Indiana, PC Internal Medicine CurrentSince Nov 11, 2024 Accepting new patients
Iu Health Medical Group, LLC CurrentSince Jan 1, 2026 Accepting new patients
Arnett Clinic, LLC CurrentSince Jul 5, 2011 Accepting new patients
Arnett Clinic, LLC Current Accepting new patients

Locations

8016 Reliable Pkwy
Chicago, IL 60686

7950 W Jefferson Blvd
Fort Wayne, IN 46804
Phone (260) 434-7088

7952 W Jefferson Blvd
Fort Wayne, IN 46804
Phone (260) 435-2836

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

550 University Blvd
Indianapolis, IN 46202
Phone (217) 274-5000

720 Eskenazi Ave
Fl 5
Indianapolis, IN 46202
Phone (317) 880-6000

2600 Greenbush St
Lafayette, IN 47904

1850 State St
New Albany, IN 47150
Phone (812) 944-7701

Organizations & group practices 5

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.

Hospital & facility affiliations 4

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": "1212364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1393891200000",
    "number": "1447419858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8910 PURDUE RD",
            "address_2": "STE 500",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462683161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 UNIVERSITY BLVD",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462025149",
            "telephone_number": "317-948-0762"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LASISI",
        "first_name": "RAUFU",
        "middle_name": "ADEFEMI",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-02",
        "last_updated": "2014-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IN",
            "license": "11013709A",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "IN",
            "license": "01067846A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200980210",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HPN MEDICARE GROUP#",
            "identifier": "205110",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HPN ANTHEM PIN#",
            "identifier": "000000672592",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM PROVIDER NUMBER / TIN 35-2030653",
            "identifier": "000000708549",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HPN MEDICAID GROUP#/LOCATION",
            "identifier": "200311740H",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.