Individual provider Active NPI

Daniel F Rexroth, PSYD

  • Clinical Neurophysiology Physician
  • Indianapolis, IN
National Provider Identifier
1508803164
Registry record updated Feb 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Neurophysiology PhysicianTaxonomy code 2084N0600X
License
20041914A Issued in IN
Practice address
355 W 16TH St
Indianapolis, IN 46202-2207
Phone
(317) 963-7300
NPI assigned
Jun 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 20041914A IN
Clinical Neurophysiology Physician 2084N0600X 20041914 IN
Clinical Neurophysiology Physician 2084N0600X 20041914A IN Primary

Addresses

Primary practice location

355 W 16TH St
Indianapolis, IN 46202-2207

Mailing address

250 N Shadeland Ave Ste 200
Indianapolis, IN 46219-4959
Phone (317) 962-3834

Other practice location 1

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

Other identifiers 2

IdentifierTypeStateIssuer
200502960MedicaidIN
P00245001OtherINRAIL ROAD MEDICARE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address DREXROTH@direct.iuhealth.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040909000027 IN Practitioner - Clinical Psychologist 1951377159 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Iu Health Medical Group LLCGroup PAC ID 9638617913, 4,382 clinicians

Practice addresses (Care Compare)

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
20041914AINMDPsychologist
20041914INMDClinical Neurophysiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Indiana Clinic-Neurology, LLC CurrentSince Aug 1, 2009 Accepting new patients
Iu Health Medical Group, LLC CurrentSince Apr 1, 2025 Accepting new patients
Indiana University Health Care Associates, Inc CurrentSince Mar 1, 2020 Accepting new patients
University Clinical Neurologists, Inc Past Accepting new patients
University Medical Diagnostic Associates, Inc. Past Accepting new patients
Clarian Neurology Group, LLC Past Accepting new patients

Locations

3879 Reliable Pkwy
Chicago, IL 60686

5208 Reliable Pkwy
Chicago, IL 60686

350 S Landmark Ave
Bloomington, IN 47403
Phone (812) 332-9874

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

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

720 Eskenazi Ave
Fl 2
Indianapolis, IN 46202
Phone (317) 278-5316

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

250 N Shadeland Ave
Ste 200
Indianapolis, IN 46219
Phone (317) 962-4836

2732 W Michigan St
Indianapolis, IN 46222
Phone (317) 554-4600

355 W 16th St
Ste 4800
Indianapolis, IN 46202
Phone (317) 963-7288

355 W 16th St
Indianapolis, IN 46202
Phone (317) 963-7070

720 Eskenazi Ave
Indianapolis, IN 46202
Phone (317) 880-0000

355 W 16th St
Ste 2800
Indianapolis, IN 46202
Phone (317) 963-7300

250 N Shadeland Ave
Ste 130
Indianapolis, IN 46219
Phone (317) 962-4836

550 University Blvd
Indianapolis, IN 46202
Phone (217) 274-5000

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

8820 S Meridian St
Indianapolis, IN 46217
Phone (317) 865-6700

Interoperability endpoints

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

Organizations & group practices 6

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": "1149120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739577600000",
    "number": "1508803164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 N SHADELAND AVE STE 200",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462194959",
            "telephone_number": "317-962-3834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "355 W 16TH ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462022207",
            "telephone_number": "317-963-7300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1701 N Senate Blvd",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462021239",
            "country_code": "US",
            "telephone_number": "888-484-3258",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REXROTH",
        "first_name": "DANIEL",
        "middle_name": "F",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-01",
        "last_updated": "2025-02-15",
        "certification_date": "2025-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "IN",
            "license": "20041914A",
            "primary": false
        },
        {
            "code": "2084N0600X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Clinical Neurophysiology",
            "state": "IN",
            "license": "20041914",
            "primary": false
        },
        {
            "code": "2084N0600X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Clinical Neurophysiology",
            "state": "IN",
            "license": "20041914A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200502960",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD MEDICARE",
            "identifier": "P00245001",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "DREXROTH@direct.iuhealth.org",
            "affiliation": "N",
            "address_1": "355 W 16th St",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "462022207",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.