Individual provider Active NPI

Brian D Hornback, MD

  • Anatomic Pathology Physician
  • Indianapolis, IN
National Provider Identifier
1528036043
Registry record updated Mar 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology PhysicianTaxonomy code 207ZP0101X
License
36371 Issued in KY
Practice address
2560 N Shadeland Ave Ste a
Indianapolis, IN 46219-1706
Phone
(800) 890-6220
Fax
(317) 275-8018
NPI assigned
Mar 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology Physician 207ZP0101X 36371 KY Primary

Addresses

Primary practice location

2560 N Shadeland Ave Ste a
Indianapolis, IN 46219-1706

Mailing address

14275 Midway Rd
Suite 400
Addison, TX 75001-3614
Phone (606) 886-8511

Other identifiers 5

IdentifierTypeStateIssuer
000000355688OtherKYBCBS
220033056OtherKYTRAVELERS
2005014-000MedicaidWV
64050552MedicaidKY
2414168MedicaidOH

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
I20140417001294 IN Practitioner - Pathology 2062582000 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Ohio State University College of Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ameripath Indianapolis PCGroup PAC ID 2961475058, 35 clinicians

Practice addresses (Care Compare)

1000 E Main St
Pathology Dept
Danville, IN 46122-1948
Phone (317) 745-3555

2001 W 86TH St
Indianapolis, IN 46260-1902
Phone (317) 338-2345

395 Westfield Rd
Pathology Department
Noblesville, IN 46060-1425
Phone (800) 890-6220

Hospital & facility affiliations

  • Riverview Health Hospital, Noblesville, IN, CCN 150059
  • Orthoindy Hospital Hospital, Indianapolis, IN, CCN 150160

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
36371KYMDAnatomic Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ameripath Kentucky Inc Current Accepting new patients
Ameripath Kentucky Inc Past Accepting new patients
Major Hospital Past Accepting new patients
Ameripath Indianapolis PC Past Accepting new patients

Locations

2620 Wilhite Dr
Ste 213
Lexington, KY 40503
Phone (859) 275-1922

989 Medical Park Dr
Maysville, KY 41056
Phone (606) 759-3112

14275 Midway Rd
Ste 400
Addison, TX 75001
Phone (214) 932-8018

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.

Hospital & facility affiliations 2

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": "1141948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711670400000",
    "number": "1528036043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14275 MIDWAY RD",
            "address_2": "SUITE 400",
            "city": "ADDISON",
            "state": "TX",
            "postal_code": "750013614",
            "telephone_number": "606-886-8511",
            "fax_number": "610-271-4245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2560 N SHADELAND AVE STE A",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462191706",
            "telephone_number": "800-890-6220",
            "fax_number": "317-275-8018"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HORNBACK",
        "first_name": "BRIAN",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-10",
        "last_updated": "2024-03-29",
        "certification_date": "2024-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0101X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology",
            "state": "KY",
            "license": "36371",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "000000355688",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRAVELERS",
            "identifier": "220033056",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2005014-000",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64050552",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2414168",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.