Individual provider Active NPI

Michael Chiebonam Obichi, M.D.

  • Family Medicine Physician
  • Indianapolis, IN
National Provider Identifier
1467615161
Registry record updated May 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
01069522A Issued in IN
Practice address
1402 E County Line Rd
Indianapolis, IN 46227-0963
Phone
(317) 887-7805
NPI assigned
Jul 3, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 17, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 01069522A IN Primary

Addresses

Primary practice location

1402 E County Line Rd
Indianapolis, IN 46227-0963

Mailing address

6626 E 75TH St
Ste 500
Indianapolis, IN 46250-2805

Other identifiers 3

IdentifierTypeStateIssuer
000000977209OtherINANTHEM
201022320MedicaidIN
P01824525OtherINRR PTAN

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address mobichi198163@eCommunityDirect.com Community Physicians of Indiana Inc
Direct Messaging Address mobichi198163@ReidHealth.direct-ci.com Reid Physician Associates, Inc.

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
I20110630000521 IN Practitioner - HospitalistPractitioner - Family Practice 5890973416 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Family Practice
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Physicians of Indiana IncGroup PAC ID 1759416662, 1,569 clinicians

Practice addresses (Care Compare)

1402 E County Line Rd
Indianapolis, IN 46227-0963
Phone (317) 887-7113

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Community Physicians of Indiana Inc CurrentSince Jan 24, 2017 Accepting new patients
Reid Physician Associates, Inc CurrentSince Jan 1, 2016 Accepting new patients
Community Physicians of Indiana Inc Family Medicine CurrentSince Jan 24, 2017 Accepting new patients
Reid Physician Associates, Inc. CurrentSince Jan 1, 2016 Accepting new patients

Locations

5819 Reliable Pkwy
Chicago, IL 60686

7120 Clearvista Dr
Ste 4000
Indianapolis, IN 46256
Phone (317) 621-7444

6626 E 75th St
Ste 500
Indianapolis, IN 46250
Phone (317) 621-7547

1100 Reid Pkwy
Richmond, IN 47374
Phone (765) 983-3000

1402 E County Line Rd
Southport, IN 46227
Phone (317) 887-7000

Interoperability endpoints

  • Direct secure messaging: mobichi198163@reidhealth.direct-ci.com
  • Direct secure messaging: mobichi198163@ecommunitydirect.com

Organizations & group practices 4

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": "1215043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621209600000",
    "number": "1467615161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6626 E 75TH ST",
            "address_2": "STE 500",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462502805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1402 E COUNTY LINE RD",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462270963",
            "telephone_number": "317-887-7805"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OBICHI",
        "first_name": "MICHAEL",
        "middle_name": "CHIEBONAM",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-03",
        "last_updated": "2021-05-17",
        "certification_date": "2021-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01069522A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000977209",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201022320",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR PTAN",
            "identifier": "P01824525",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mobichi198163@eCommunityDirect.com",
            "affiliation": "Y",
            "affiliationName": "Community Physicians of Indiana Inc",
            "address_1": "1402 E County Line Rd",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "462270963",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mobichi198163@ReidHealth.direct-ci.com",
            "affiliation": "Y",
            "affiliationName": "Reid Physician Associates, Inc.",
            "address_1": "1100 Reid Pkwy",
            "city": "Richmond",
            "state": "IN",
            "country_code": "US",
            "postal_code": "473741157",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.