Individual provider Active NPI

Kieren J Mather, M.D.

  • Endocrinology, Diabetes & Metabolism Physician
  • Indianapolis, IN
National Provider Identifier
1528022340
Registry record updated Mar 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
01051373A Issued in IN
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

Updated by the provider on Mar 30, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
200318510MedicaidIN

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100107000005 IN Practitioner - EndocrinologyPractitioner - Internal Medicine 5092856450 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01051373INMDEndocrinology, Diabetes & Metabolism Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Indiana University Health Care Associates, Inc CurrentSince Feb 13, 2020 Accepting new patients
Iu Health Medical Group, LLC CurrentSince Jul 1, 2025 Accepting new patients
University Medical Diagnostic Associates, Inc. Endocrinology, Diabetes & Metabolism CurrentSince Jul 1, 2000 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

  • Direct secure messaging: 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.

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

Verify at the official NPI Registry.