Individual provider Active NPI

Marcus J Magnussen, DO

  • Neurology Physician
  • Indianapolis, IN
National Provider Identifier
1457678187
Registry record updated Mar 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
02004577A Issued in IN
Practice address
1400 N Ritter Ave Ste 220
Indianapolis, IN 46219-3046
Phone
(317) 715-5600
Fax
(317) 715-5618
NPI assigned
Apr 20, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 02004577A IN Primary

Addresses

Primary practice location

1400 N Ritter Ave Ste 220
Indianapolis, IN 46219-3046

Mailing address

6983 Hillsdale CT
Indianapolis, IN 46250-2054
Phone (317) 849-8350

Other identifiers 1

IdentifierTypeStateIssuer
201303980MedicaidIN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address referrals@jwmn.gwaydirect.com 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
I20150615000976 IN Practitioner - Neurology 3375854565 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Josephson-Wallack-Munshower Neurology PCGroup PAC ID 6709868870, 59 clinicians

Practice addresses (Care Compare)

12188 A N Meridian St
Suite 320
Carmel, IN 46032-4407
Phone (317) 580-0420

1400 N Ritter Ave
Suite 220
Indianapolis, IN 46219-3049
Phone (317) 715-5600

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
69.89 of 100Reported as group
Promoting interoperability
56
Improvement activities
40
Cost
76.39

Procedures performed for Medicare patients

ProcedureNumber of procedures
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
02004577AINMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Daviess County Hospital CurrentSince Jun 1, 2023 Accepting new patients
Daviess County Hospital Current Accepting new patients
Josephson-Wallack-Munshower Neurology PC Neurology CurrentSince Aug 1, 2015 Accepting new patients
Daviess County Hospital CurrentSince Jun 1, 2023 Accepting new patients
Major Hospital Past Accepting new patients
Josephson-Wallack-Munshower Neurology PC Neurology Past Accepting new patients

Locations

12188A N Meridian St
Ste 320
Carmel, IN 46032
Phone (317) 580-0420

1400 N Ritter Ave
Ste 220
Indianapolis, IN 46219
Phone (317) 355-1555

6983 Hillsdale Ct
Indianapolis, IN 46250

1400 N Ritter Ave
Ste 120
Indianapolis, IN 46219
Phone (317) 355-1000

2330 S Dixon Rd
Ste 325
Kokomo, IN 46902
Phone (765) 455-8822

1314 E Walnut St
Washington, IN 47501
Phone (812) 254-2250

1402 Grand Ave
Washington, IN 47501
Phone (812) 254-2250

Interoperability endpoints

  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.441.1753
  • Direct secure messaging: mmagnussen204568@direct.franciscanalliance.org
  • Direct secure messaging: mmagnussen@jwmn.gwaydirect.com

Organizations & group practices 6

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": "1271721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616457600000",
    "number": "1457678187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6983 HILLSDALE CT",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462502054",
            "telephone_number": "317-849-8350",
            "fax_number": "317-576-6311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 N RITTER AVE STE 220",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462193046",
            "telephone_number": "317-715-5600",
            "fax_number": "317-715-5618"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAGNUSSEN",
        "first_name": "MARCUS",
        "middle_name": "J",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-04-20",
        "last_updated": "2021-03-23",
        "certification_date": "2021-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "IN",
            "license": "02004577A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201303980",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "referrals@jwmn.gwaydirect.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1400 N Ritter Ave Ste 220",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "462193046",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.