Individual provider Active NPI

Richard Brian Stall Jr., CAA

  • Anesthesiology Physician
  • Indianapolis, IN
National Provider Identifier
1487102356
Registry record updated Feb 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
75000005A Issued in IN
Practice address
1701 N Senate Blvd
Indianapolis, IN 46202-1239
Phone
(317) 962-8880
NPI assigned
Sep 20, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiologist Assistant 367H00000X 75000005A IN
Anesthesiology Physician 207L00000X 75000005A IN Primary

Addresses

Primary practice location

1701 N Senate Blvd
Indianapolis, IN 46202-1239

Mailing address

250 N Shadeland Ave
Indianapolis, IN 46219-4959

Other practice location 1

320 Whittington Pkwy
Suite 301
Louisville, KY 40222-4928
Phone (502) 625-5584

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address rstall@direct.iuhealth.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN, VT, NC3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20170201000256 IN Practitioner - Anesthesiology Assistant 1052693843 Reassigns benefits to 2 organizations
I20220413001247 VT Practitioner - Anesthesiology Assistant 1052693843 Reassigns benefits to 1 organization
I20251125003508 NC Practitioner - Anesthesiology Assistant 1052693843 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology Assistant
Education
Nova Southeastern College of Osteo Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rutland Hospital, Inc.Group PAC ID 7214846377, 186 clinicians
Iu Health Medical Group LLCGroup PAC ID 9638617913, 4,382 clinicians

Practice addresses (Care Compare)

160 Allen St
Rutland, VT 05701-4560
Phone (802) 775-7111

1701 N Senate Blvd
Indianapolis, IN 46202-1239
Phone (888) 484-3258

2308 Wesvill CT
Raleigh, NC 27607-2949
Phone (919) 873-9533

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Associate of Arts

Practice roles

OrganizationSpecialtyStatusNew patients
Rutland Hospital, Inc. CurrentSince Aug 24, 2022 Accepting new patients
Mid Vermont Pathology PC Current Accepting new patients
Rutland Hospital, Inc. CurrentSince Aug 24, 2022 Accepting new patients
Iu Health Medical Group, LLC CurrentSince Jan 27, 2025 Accepting new patients
American Anesthesiology of North Carolina, PLLC Anesthesiology CurrentSince Jan 1, 2026 Accepting new patients
American Anesthesiology of North Carolina, PLLC Anesthesiology CurrentSince Jan 1, 2026 Accepting new patients
One Anesthesia PLLC Anesthesiology CurrentSince Oct 13, 2016 Accepting new patients
Rutland Hospital, Inc. Past Accepting new patients
U S Anesthesia Partners of Kentucky PSC Anesthesiology PastSince Jul 1, 2023 Accepting new patients

Locations

1701 Senate Blvd
Indianapolis, IN 46202
Phone (317) 612-2754

250 N Shadeland Ave
Indianapolis, IN 46219
Phone (317) 948-9174

1220 Missouri Ave
Rm 2547
Jeffersonville, IN 47130

1850 State St
New Albany, IN 47150
Phone (812) 944-7701

320 Whittington Pkwy
Ste 301
Louisville, KY 40222
Phone (502) 625-5584

4420 Lake Boone Trl
Raleigh, NC 27607
Phone (919) 784-3034

2308 Wesvill Ct
Raleigh, NC 27607
Phone (919) 278-7762

3100 Spring Forest Rd
Ste 130
Raleigh, NC 27616
Phone (919) 882-0705

100 Hospital Dr
Bennington, VT 05201
Phone (802) 447-4509

160 Allen St
Rutland, VT 05701

Interoperability endpoints

  • Direct secure messaging: rstall@direct.iuhealth.org

Organizations & group practices 9

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 2

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": "1474329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739750400000",
    "number": "1487102356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 N SHADELAND AVE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462194959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 N SENATE BLVD",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462021239",
            "telephone_number": "317-962-8880"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "320 Whittington Pkwy",
            "address_2": "Suite 301",
            "address_purpose": "LOCATION",
            "city": "Louisville",
            "state": "KY",
            "postal_code": "402224928",
            "country_code": "US",
            "telephone_number": "502-625-5584",
            "fax_number": "502-426-2264",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STALL",
        "first_name": "RICHARD",
        "middle_name": "BRIAN",
        "name_suffix": "Jr.",
        "credential": "CAA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-09-20",
        "last_updated": "2025-02-17",
        "certification_date": "2025-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367H00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiologist Assistant",
            "state": "IN",
            "license": "75000005A",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IN",
            "license": "75000005A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rstall@direct.iuhealth.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1701 N Senate Blvd",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "462021239",
            "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 Feb 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.