Individual provider Active NPI

Abdolaziz M Ardalan, M.D

  • Vascular Surgery Physician
  • Indianapolis, IN
National Provider Identifier
1487761607
Registry record updated Sep 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
010267201 Issued in IN
Practice address
9737 Decatur Dr
Indianapolis, IN 46256-9656
Phone
(317) 578-1133
Fax
(317) 843-2727
NPI assigned
Aug 24, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 6, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery Physician 2086S0129X 010267201 IN Primary

Addresses

Primary practice location

9737 Decatur Dr
Indianapolis, IN 46256-9656

Mailing address

9737 Decatur Dr
Indianapolis, IN 46256-9656
Phone (317) 578-1133

Other identifiers 2

IdentifierTypeStateIssuer
100367790AMedicaidIN
000000079426OtherINANTHEM BLUE SHIELD

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
010267201INMDVascular Surgery Physician

NPI Registry JSON

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

{
    "created_epoch": "1156377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788652800000",
    "number": "1487761607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9737 DECATUR DR",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462569656",
            "telephone_number": "317-578-1133",
            "fax_number": "317-537-2862"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9737 DECATUR DR",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462569656",
            "telephone_number": "317-578-1133",
            "fax_number": "317-843-2727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARDALAN",
        "first_name": "ABDOLAZIZ",
        "middle_name": "M",
        "name_prefix": "Mr.",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-24",
        "last_updated": "2026-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "IN",
            "license": "010267201",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100367790A",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BLUE SHIELD",
            "identifier": "000000079426",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "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 Sep 6, 2026; 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.