Active NPI
Kieren J Mather, M.D.
- Endocrinology, Diabetes & Metabolism Physician
- Indianapolis, IN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Endocrinology, Diabetes & Metabolism Physician
- License
- 01051373A
- Practice address
- 975 W Walnut St
Ib 424
Indianapolis, IN 46202-5181 - Phone
- (317) 944-8660
- NPI assigned
- Apr 17, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Endocrinology, Diabetes & Metabolism Physician | 207RE0101X | 01051373 | IN | |
| Endocrinology, Diabetes & Metabolism Physician | 207RE0101X | 01051373A | IN | Primary |
Addresses
Primary practice location
975 W Walnut St
Ib 424
Indianapolis, IN 46202-5181
Mailing address
250 N Shadeland Ave Ste 200
Indianapolis, IN 46219-4959
Phone (317) 962-3834
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200318510 | Medicaid | IN |
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: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01051373 | IN | MD | Endocrinology, Diabetes & Metabolism Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Indiana University Health Care Associates, Inc | Current | Accepting new patients | |
| Iu Health Medical Group, LLC | Current | Accepting new patients | |
| University Medical Diagnostic Associates, Inc. | Endocrinology, Diabetes & Metabolism | Current | Accepting new patients |
| Major Hospital | Past | Accepting new patients | |
| Lima Memorial Joint Operating Company | Past | Accepting new patients |
Locations
5208 Reliable Pkwy
Chicago, IL 60686
7301 Solutions Ctr
Chicago, IL 60677
7301 Solutions Ctr
#777301
Chicago, IL 60677
Phone (317) 962-4777
550 University Blvd
Indianapolis, IN 46202
Phone (217) 274-5000
975 W Walnut St
#424
Indianapolis, IN 46202
1701 Senate Blvd
Indianapolis, IN 46202
Phone (317) 612-2754
250 N Shadeland Ave
Ste 200
Indianapolis, IN 46219
Phone (317) 962-4836
1701 N Senate Blvd
Bldg C6
Indianapolis, IN 46202
Phone (913) 962-2000
Interoperability endpoints
- kmather13764@direct.eskenazihealth.edu
Organizations & group practices 5
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.
-
- General Practice Physician
- Indianapolis, IN
- NPI 1902032832
-
- General Practice Physician
- Indianapolis, IN
- NPI 1326893777
-
- Internal Medicine Physician
- Indianapolis, IN
- NPI 1861441537
Endocrinology, Diabetes & Metabolism
-
- General Acute Care Hospital
- Shelbyville, IN
- NPI 1174555692
-
- General Acute Care Hospital
- Lima, OH
- NPI 1336144732
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1145232000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1585526400000",
"number": "1528022340",
"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": "975 W WALNUT ST",
"address_2": "IB 424",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462025181",
"telephone_number": "317-944-8660"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MATHER",
"first_name": "KIEREN",
"middle_name": "J",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-04-17",
"last_updated": "2020-03-30",
"certification_date": "2020-03-30",
"status": "A"
},
"taxonomies": [
{
"code": "207RE0101X",
"taxonomy_group": "",
"desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
"state": "IN",
"license": "01051373",
"primary": false
},
{
"code": "207RE0101X",
"taxonomy_group": "",
"desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
"state": "IN",
"license": "01051373A",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200318510",
"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 Mar 30, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.