Active NPI
Stephen James Mahoney, M.D.
- Gastroenterology Physician
- Indianapolis, IN
National Provider Identifier
1538165378
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gastroenterology Physician
- License
- 01026306
- Practice address
- 8051 S Emerson Ave
Ste 200
Indianapolis, IN 46237-8632 - Phone
- (317) 865-2955
- Fax
- (317) 865-2944
- NPI assigned
- Jun 27, 2005
- Last updated
- Jun 15, 2010
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gastroenterology Physician | 207RG0100X | 01026306 | IN | Primary |
Addresses
Primary practice location
8051 S Emerson Ave
Ste 200
Indianapolis, IN 46237-8632
Mailing address
8051 S Emerson Ave
Ste 200
Indianapolis, IN 46237-8632
Phone (317) 865-2955
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100365940 | Medicaid | IN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01026306 | IN | MD | Gastroenterology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Major Hospital | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
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- Shelbyville, IN
- NPI 1174555692
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1119830400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1276560000000",
"number": "1538165378",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8051 S EMERSON AVE",
"address_2": "STE 200",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462378632",
"telephone_number": "317-865-2955",
"fax_number": "317-865-2944"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8051 S EMERSON AVE",
"address_2": "STE 200",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462378632",
"telephone_number": "317-865-2955",
"fax_number": "317-865-2944"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAHONEY",
"first_name": "STEPHEN",
"middle_name": "JAMES",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-06-27",
"last_updated": "2010-06-15",
"status": "A"
},
"taxonomies": [
{
"code": "207RG0100X",
"taxonomy_group": "",
"desc": "Internal Medicine, Gastroenterology",
"state": "IN",
"license": "01026306",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100365940",
"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 Jun 15, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.