Individual provider Active NPI

Justin David Smith, MD

  • Emergency Medicine Physician
  • Indianapolis, IN
National Provider Identifier
1497496459
Registry record updated Jun 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
01089817A Issued in IN
Practice address
1701 N Senate Blvd RM Ag012
Indianapolis, IN 46202-1239
Phone
(317) 962-5975
NPI assigned
Apr 5, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Emergency Medicine Physician 207P00000X 01089817A IN Primary

Addresses

Primary practice location

1701 N Senate Blvd RM Ag012
Indianapolis, IN 46202-1239

Mailing address

1701 N Senate Blvd RM Ag012
Indianapolis, IN 46202-1239
Phone (317) 962-5975

Other practice location 1

2651 E Discovery Pkwy
Bloomington, IN 47408-9059
Phone (812) 353-9515

Other identifiers 3

IdentifierTypeStateIssuer
1103692253OtherINANTHEM PTAN
300063763MedicaidIN
264430I01OtherINMEDICARE PTAN

Electronic endpoints 2

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

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN, KY2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20230828000806 IN Practitioner - Emergency Medicine 6305225368 Reassigns benefits to 3 organizations
I20250815000487 KY Practitioner - Emergency Medicine 6305225368 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Methodist Health, Inc.Group PAC ID 4981508454, 69 clinicians
Deaconess Hospital, Inc.Group PAC ID 9032021431, 410 clinicians

Practice addresses (Care Compare)

1305 N Elm St
Henderson, KY 42420-2783
Phone (270) 827-7100

4011 Gateway Blvd
Newburgh, IN 47630-8947
Phone (812) 450-7299

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01089817AINMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Methodist Health, Inc. CurrentSince Jul 21, 2025 Accepting new patients
Deaconess Hospital, Inc Emergency Medicine CurrentSince Jul 1, 2025 Accepting new patients
Deaconess Hospital Inc CurrentSince Jul 1, 2025 Accepting new patients
Indiana University Health Southern Indiana Physicians LLC CurrentSince Aug 1, 2024 Accepting new patients
Indiana University Health Care Associates, Inc CurrentSince Oct 1, 2023 Accepting new patients
Methodist Health, Inc. Emergency Medicine CurrentSince Jul 21, 2025 Accepting new patients
Deaconess Hospital, Inc Current Accepting new patients
Indiana University Health Southern Indiana Physicians, LLC Emergency Medicine CurrentSince Aug 1, 2024 Accepting new patients
University Medical Diagnostic Associates, Inc. Past Accepting new patients

Locations

5208 Reliable Pkwy
Chicago, IL 60686

2651 E Discovery Pkwy
Bloomington, IN 47408
Phone (812) 353-9147

727 W 2nd St
Bloomington, IN 47403
Phone (812) 353-3450

600 Mary St
Evansville, IN 47710
Phone (812) 450-2239

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

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

1701 N Senate Blvd
Bldg C6
Indianapolis, IN 46202
Phone (913) 962-2000

4011 Gateway Blvd
Newburgh, IN 47630
Phone (812) 450-2240

1305 N Elm St
Henderson, KY 42420
Phone (270) 827-7100

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 3

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": "1649116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718323200000",
    "number": "1497496459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1701 N SENATE BLVD RM AG012",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462021239",
            "telephone_number": "317-962-5975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 N SENATE BLVD RM AG012",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462021239",
            "telephone_number": "317-962-5975"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2651 E Discovery Pkwy",
            "address_purpose": "LOCATION",
            "city": "Bloomington",
            "state": "IN",
            "postal_code": "474089059",
            "country_code": "US",
            "telephone_number": "812-353-9515",
            "fax_number": "812-353-9275",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JUSTIN",
        "middle_name": "DAVID",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-04-05",
        "last_updated": "2024-06-14",
        "certification_date": "2024-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IN",
            "license": "01089817A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM PTAN",
            "identifier": "1103692253",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300063763",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "264430I01",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jsmith@direct.iuhealth.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1701 N Senate Blvd Rm Ag012",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "462021239",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jsmith@direct.iuhealth.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2651 E Discovery Pkwy",
            "city": "Bloomington",
            "state": "IN",
            "country_code": "US",
            "postal_code": "474089059",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.