Individual provider Active NPI

Murugavel M Muthusamy, M.D.

  • Hematology & Oncology Physician
  • Fort Wayne, IN
National Provider Identifier
1467420760
Registry record updated Jan 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
01040972A Issued in IN
Practice address
11050 Parkview Circle Dr
Fort Wayne, IN 46845-1739
Phone
(833) 724-8326
Fax
(260) 425-6845
NPI assigned
Mar 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X 23416-875 WI
Hematology & Oncology Physician 207RH0003X 36148444 IL
Hematology & Oncology Physician 207RH0003X 01040972A IN Primary

Addresses

Primary practice location

11050 Parkview Circle Dr
Fort Wayne, IN 46845-1739

Mailing address

4101 Technology Ave
New Albany, IN 47150-8548
Phone (812) 941-4500

Other practice location 1

4101 Technology Ave
New Albany, IN 47150-8548
Phone (812) 941-4500

Other identifiers 5

IdentifierTypeStateIssuer
5171410005OtherINDMERC
5171410004OtherDMERC
100219024MedicaidWI
100361800MedicaidIN
5171410003OtherDMERC

Electronic endpoints 7

TypeEndpointUseAffiliation
Direct Messaging Address mmuthusamy359587@direct.myadvocateaurora.org Direct
Direct Messaging Address mmuthusamy299317@direct-ehr-ssmhc.com Direct
Direct Messaging Address murugavel.muthusamymd.p36@direct.ahni.nextgenshare.com Direct
FHIR URL https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/ Other
FHIR URL https://epicprod-mobile.parkview.com/FHIR/api/FHIR/R4/
FHIR URL https://epicprod-mobile.parkview.com/FHIR/api/FHIR/DSTU2/
Direct Messaging Address mmuthusamy587609@Direct.Parkviewexchange.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN, IL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20040803000072 IN Practitioner - Hematology/OncologyPractitioner - Internal MedicinePractitioner - Medical Oncology 1850362062 Reassigns benefits to 1 organization
I20190418000546 IL Practitioner - Hematology/Oncology 1850362062 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hematology/OncologyAlso: Internal Medicine
Education
Other, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Parkview Health System IncGroup PAC ID 2163336967, 1,350 clinicians

Practice addresses (Care Compare)

11050 Parkview Circle Dr
Fort Wayne, IN 46845-1739
Phone (833) 724-8326

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
36148444ILMDHematology & Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Parkview Health System Inc CurrentSince Oct 27, 2023 Accepting new patients
Physician Services Corporation of Southern Illinois Inc. CurrentSince Apr 1, 2019 Accepting new patients
American Health Network of Indiana, LLC Hematology & Oncology CurrentSince Dec 10, 2020 Accepting new patients
American Health Network of Indiana LLC CurrentSince Dec 10, 2020 Accepting new patients
Health & Oncology Services, Inc Hematology & Oncology Past Accepting new patients
Hospice of the Calumet Area, Inc. Past Accepting new patients

Locations

1052 Martin Luther King Dr
Ste 100
Centralia, IL 62801
Phone (618) 436-6479

2 Good Samaritan Way
Ste 320
Mount Vernon, IL 62864
Phone (618) 899-1944

817 Trail Ridge Rd
Albion, IN 46701
Phone (260) 373-9590

10689 N Pennsylvania St
Ste 200
Carmel, IN 46280
Phone (317) 580-6309

100 Hospital Ln
Ste 320
Danville, IN 46122
Phone (317) 520-5510

10995 Allisonville Rd
Ste 100
Fishers, IN 46038
Phone (317) 842-7928

11050 Parkview Circle Dr
Fort Wayne, IN 46845
Phone (260) 266-7100

240 S Jefferson St
Ste B
Huntington, IN 46750
Phone (219) 259-0000

7440 Woodland Dr
Indianapolis, IN 46278
Phone (317) 450-3357

8301 Harcourt Rd
Ste 205
Indianapolis, IN 46260
Phone (317) 228-3393

4101 Technology Ave
New Albany, IN 47150
Phone (812) 941-4500

150 W Washington St
Shelbyville, IN 46176
Phone (317) 392-3211

3221 McKelvey Rd
Ste 301
Bridgeton, MO 63044

Interoperability endpoints

  • Direct secure messaging: murugavel.muthusamy@chtc.ikm.direct-ci.com
  • Direct secure messaging: mmuthusamy359587@direct.myadvocateaurora.org
  • Direct secure messaging: mmuthusamy587609@direct.parkviewexchange.com
  • Direct secure messaging: murugavel.muthusamymd.p36@direct.ahni.nextgenshare.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 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": "1141948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704153600000",
    "number": "1467420760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4101 TECHNOLOGY AVE",
            "city": "NEW ALBANY",
            "state": "IN",
            "postal_code": "471508548",
            "telephone_number": "812-941-4500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11050 PARKVIEW CIRCLE DR",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468451739",
            "telephone_number": "833-724-8326",
            "fax_number": "260-425-6845"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4101 Technology Ave",
            "address_purpose": "LOCATION",
            "city": "New Albany",
            "state": "IN",
            "postal_code": "471508548",
            "country_code": "US",
            "telephone_number": "812-941-4500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MUTHUSAMY",
        "first_name": "MURUGAVEL",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-10",
        "last_updated": "2024-01-02",
        "certification_date": "2024-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "WI",
            "license": "23416-875",
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "IL",
            "license": "36148444",
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "IN",
            "license": "01040972A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DMERC",
            "identifier": "5171410005",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DMERC",
            "identifier": "5171410004",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100219024",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100361800",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DMERC",
            "identifier": "5171410003",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mmuthusamy359587@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "4101 Technology Ave",
            "city": "New Albany",
            "state": "IN",
            "country_code": "US",
            "postal_code": "471508548",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mmuthusamy299317@direct-ehr-ssmhc.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "mmuthusamy299317@direct-ehr-ssmhc.com",
            "address_1": "1052 Martin Luther King Dr Ste 100",
            "city": "Centralia",
            "state": "IL",
            "country_code": "US",
            "postal_code": "628013002",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "murugavel.muthusamymd.p36@direct.ahni.nextgenshare.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "8301 Harcourt Rd Ste 205",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "462602082",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "1052 Martin Luther King Dr Ste 100",
            "city": "Centralia",
            "state": "IL",
            "country_code": "US",
            "postal_code": "628013002",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicprod-mobile.parkview.com/FHIR/api/FHIR/R4/",
            "affiliation": "N",
            "address_1": "11050 Parkview Circle Dr",
            "city": "Fort Wayne",
            "state": "IN",
            "country_code": "US",
            "postal_code": "468451739",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicprod-mobile.parkview.com/FHIR/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "11050 Parkview Circle Dr",
            "city": "Fort Wayne",
            "state": "IN",
            "country_code": "US",
            "postal_code": "468451739",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mmuthusamy587609@Direct.Parkviewexchange.com",
            "affiliation": "N",
            "address_1": "11050 Parkview Circle Dr",
            "city": "Fort Wayne",
            "state": "IN",
            "country_code": "US",
            "postal_code": "468451739",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

Verify at the official NPI Registry.