Active NPI
Abdolaziz M Ardalan, M.D
- Vascular Surgery Physician
- Indianapolis, IN
National Provider Identifier
1487761607
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Vascular Surgery Physician
- License
- 010267201
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100367790A | Medicaid | IN | |
| 000000079426 | Other | IN | ANTHEM 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
| License | State | Type | Specialty |
|---|---|---|---|
| 010267201 | IN | MD | Vascular 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.