Individual provider Active NPI

Brian Carlo Mariano David, MD

  • Internal Medicine Physician
  • Muncie, IN
National Provider Identifier
1447711452
Registry record updated Jun 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
01086440A Issued in IN
Practice address
2401 W University Ave
Muncie, IN 47303-3428
Phone
(765) 741-1515
Fax
(765) 751-5087
NPI assigned
Mar 31, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X 01086440A IN Primary

Addresses

Primary practice location

2401 W University Ave
Muncie, IN 47303-3428

Mailing address

250 N Shadeland Ave
Indianapolis, IN 46219-4959

Other practice location 1

2525 W University Ave Ste 401
Muncie, IN 47303-3433
Phone (765) 747-4306

Other practice location 2

2651 E Discovery Pkwy
Bloomington, IN 47408-9059
Phone (812) 676-4102

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address bdavid@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
I20211005002581 IN Practitioner - Internal Medicine 1254666563 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Iu Health Medical Group LLCGroup PAC ID 9638617913, 4,382 clinicians
Indiana University Health Southern Indiana Physicians LLCGroup PAC ID 6204748197, 474 clinicians

Practice addresses (Care Compare)

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

2651 E Discovery Pkwy
Bloomington, IN 47408-9059
Phone (812) 353-9250

Hospital & facility affiliations

  • Indiana University Health Bloomington Hospital Hospital, Bloomington, IN, CCN 150051
  • Indiana University Health Bedford Hospital Hospital, Bedford, IN, CCN 151328
  • Indiana University Health Hospital, Indianapolis, IN, CCN 150056
  • Monroe Hospital Hospital, Bloomington, IN, CCN 150183

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01086440AINMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Indiana University Health Southern Indiana Physicians, LLC Internal Medicine CurrentSince Aug 21, 2022 Accepting new patients
Iu Health Medical Group, LLC CurrentSince Jan 1, 2026 Accepting new patients
Indiana University Health Southern Indiana Physicians LLC CurrentSince Aug 21, 2022 Accepting new patients

Locations

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

221 N Celia Ave
Muncie, IN 47303
Phone (765) 747-3141

2401 W University Ave
Muncie, IN 47303
Phone (765) 747-3111

2525 W University Ave
Muncie, IN 47303
Phone (317) 289-6166

2525 W University Ave
Ste 401
Muncie, IN 47303
Phone (765) 286-0236

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.

Hospital & facility affiliations 5

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": "1553990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655856000000",
    "number": "1447711452",
    "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": "2401 W UNIVERSITY AVE",
            "city": "MUNCIE",
            "state": "IN",
            "postal_code": "473033428",
            "telephone_number": "765-741-1515",
            "fax_number": "765-751-5087"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2525 W University Ave Ste 401",
            "address_purpose": "LOCATION",
            "city": "Muncie",
            "state": "IN",
            "postal_code": "473033433",
            "country_code": "US",
            "telephone_number": "765-747-4306",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2651 E Discovery Pkwy",
            "address_purpose": "LOCATION",
            "city": "Bloomington",
            "state": "IN",
            "postal_code": "474089059",
            "country_code": "US",
            "telephone_number": "812-676-4102",
            "fax_number": "812-676-4106",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVID",
        "first_name": "BRIAN CARLO",
        "middle_name": "MARIANO",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-31",
        "last_updated": "2022-06-22",
        "certification_date": "2022-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IN",
            "license": "01086440A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bdavid@direct.iuhealth.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2401 W University Ave",
            "city": "Muncie",
            "state": "IN",
            "country_code": "US",
            "postal_code": "473033428",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Muncie, IN

Sources for this page

Verify at the official NPI Registry.