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Shadeland Anesthesia & Pain Associates Inc.

Organization Active NPI Interventional Pain Medicine Physician · Indianapolis, IN

NPI 1477589000 · NPPES record last updated Apr 11, 2025

Key facts

NPI
1477589000
Entity type
Organization (NPI type 2)
Primary specialty
Interventional Pain Medicine Physician 208VP0014X
License
154505 (IN)
Legal business name
SHADELAND ANESTHESIA & PAIN ASSOCIATES INC.
Practice address
8805 N Meridian St
Indianapolis, IN 46260-2332
Phone
(317) 706-7246
Fax
(317) 706-3419
NPI assigned
Jun 24, 2006
Organization subpart
No

Authorized official

Name
Edward Kowlowitz, MD NPI 1972590529
Title
Owner
Phone
(317) 706-7246

Authorized official NPPES reports the authorized official by name only; the link goes to the one practitioner connected to this organization with that name.

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Practitioners 61

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 61

Medicare participation

Medicare fee-for-service enrollment
Enrolled in IN

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20040628000781 IN Part B Supplier - Clinic/Group Practice 2769468990 Receives reassigned benefits from 57 practitioners
Practice locations: Indianapolis, IN; Rockport, IN; Munster, IN; Lafayette, IN; Kokomo, IN; Jasper, IN; Greenwood, IN; Fishers, IN…

National Provider Directory

Locations

4600 Linton Blvd
Ste 340
Delray Beach, FL 33445
Phone (561) 495-9797

4425 Reliable Pkwy
Chicago, IL 60686

97 Dover St
Avon, IN 46123

97 Dover St
Ste 100
Avon, IN 46123

97 Dover St
Ste A
Avon, IN 46123

11595 N Meridian St
Ste 402
Carmel, IN 46032

11595 N Meridian St
Carmel, IN 46032
Phone (317) 509-0066

11595 N Meridian St
Ste 4002
Carmel, IN 46032

8805 N Meridian St
Ste 300
Indianapolis, IN 46260

9002 N Meridian St
Ste 209
Indianapolis, IN 46260
Phone (317) 750-3452

1 American Sq
Ste 165
Indianapolis, IN 46282
Phone (317) 955-3988

690 2nd St
Jasper, IN 47546
Phone (812) 478-5437

2302 S Dixon Rd
Kokomo, IN 46902
Phone (317) 455-0477

3738 Landmark Dr
Lafayette, IN 47905

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Pain Medicine Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 208VP0014X 154505 IN Yes
Nurse Practitioner
Group: 193200000X MULTI-SPECIALTY GROUP		 363L00000X
Family Nurse Practitioner
Group: 193200000X MULTI-SPECIALTY GROUP		 363LF0000X

Addresses

Primary practice location

8805 N Meridian St
Indianapolis, IN 46260-2332

Mailing address

29943 Network PL
Chicago, IL 60673-1299
Phone (317) 706-3415

Other identifiers

IdentifierTypeStateIssuer
200160550AMedicaidIN

Other names

  • Center for Pain Management Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Apr 11, 2025.

{
    "created_epoch": "1151107200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1744329600000",
    "number": "1477589000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29943 NETWORK PL",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606731299",
            "telephone_number": "317-706-3415",
            "fax_number": "317-706-3419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8805 N MERIDIAN ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462602332",
            "telephone_number": "317-706-7246",
            "fax_number": "317-706-3419"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHADELAND ANESTHESIA & PAIN ASSOCIATES INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-24",
        "last_updated": "2025-04-11",
        "certification_date": "2025-04-11",
        "status": "A",
        "authorized_official_last_name": "KOWLOWITZ",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "317-706-7246",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "IN",
            "license": "154505",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200160550A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Center for Pain Management",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Center for Pain Management",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Indianapolis, IN

All providers in Indianapolis, IN · Interventional Pain Medicine Physician in Indiana

Sources for this page

Verify at the official NPI Registry.