Individual provider Active NPI

Gregory J Pulawski, MD

  • Surgery Physician
  • Indianapolis, IN
National Provider Identifier
1477647600
Registry record updated Aug 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
01059913 Issued in IN
Practice address
310 E 96TH St Ste 200
Indianapolis, IN 46240-3702
Phone
(317) 344-9490
NPI assigned
Oct 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 01059913 IN Primary

Addresses

Primary practice location

310 E 96TH St Ste 200
Indianapolis, IN 46240-3702

Mailing address

9615 Irishmans Run LN
Zionsville, IN 46077-8375
Phone (317) 663-3137

Other identifiers 1

IdentifierTypeStateIssuer
200515550MedicaidIN

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address gregory.pulawskimd.p4@direct.ahni.nextgenshare.com Direct
Direct Messaging Address gpulawski1477647600@direct.d4d.ihie.us Franciscan Health Indianapolis & Mooresville

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01059913INMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pulawskimd, LLC Surgery CurrentSince Sep 5, 2023 Accepting new patients

Locations

310 E 96th St
Ste 200
Indianapolis, IN 46240
Phone (317) 344-9490

Interoperability endpoints

  • Direct secure messaging: gregory.pulawskimd.p4@direct.ahni.nextgenshare.com

Organizations & group practices 1

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692835200000",
    "number": "1477647600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9615 IRISHMANS RUN LN",
            "city": "ZIONSVILLE",
            "state": "IN",
            "postal_code": "460778375",
            "telephone_number": "317-663-3137"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 E 96TH ST STE 200",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462403702",
            "telephone_number": "317-344-9490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PULAWSKI",
        "first_name": "GREGORY",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2023-08-24",
        "certification_date": "2023-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IN",
            "license": "01059913",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200515550",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "gregory.pulawskimd.p4@direct.ahni.nextgenshare.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "7151 Marsh Rd Ste 150",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "462781631",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "gpulawski1477647600@direct.d4d.ihie.us",
            "affiliation": "Y",
            "affiliationName": "Franciscan Health Indianapolis & Mooresville",
            "address_1": "5230A East Stop 11 Road",
            "address_2": "Suite 250",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "462376399",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.