Individual provider Active NPI

Emily Mazanowski, P.A.

  • Physician Assistant
  • Fishers, IN
National Provider Identifier
1548661986
Registry record updated Jun 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
10001757A Issued in IN
Practice address
10412 Allisonville Rd Ste 100
Fishers, IN 46038-2030
Phone
(317) 572-2240
Fax
(317) 572-2235
NPI assigned
Sep 4, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 10001757A IN Primary

Addresses

Primary practice location

10412 Allisonville Rd Ste 100
Fishers, IN 46038-2030

Mailing address

6626 E 75TH St Ste 500
Indianapolis, IN 46250-2890

Other practice location 1

7930 N Shadeland Ave
Indianapolis, IN 46250-2041
Phone (317) 621-6725

Other identifiers 3

IdentifierTypeStateIssuer
000000899969OtherANTHEM
OPRMedicaidIN
300005118MedicaidIN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address amazanowski126647@eCommunityDirect.com Community Physicians of Indiana Inc

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141105001494 IN Practitioner - Physician Assistant 6406078534 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Physicians of Indiana IncGroup PAC ID 1759416662, 1,569 clinicians

Practice addresses (Care Compare)

10412 Allisonville Rd
Suite 100
Fishers, IN 46038-2030
Phone (317) 572-2240

1400 N Ritter Ave
Indianapolis, IN 46219-3049

1400 N Ritter Ave
Suite 510
Indianapolis, IN 46219-3025
Phone (317) 355-2050

1500 N Ritter Ave
Indianapolis, IN 46219-3027

7120 Clearvista Dr
Suite 4000
Indianapolis, IN 46256-1774
Phone (317) 621-7444

7150 Clearvista Dr
Indianapolis, IN 46256-1695
Phone (317) 621-6262

7930 N Shadeland Ave
Suite 100
Indianapolis, IN 46250-2943
Phone (317) 621-6725

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Fort Wayne Orthopaedics, LLC CurrentSince Oct 23, 2014 Accepting new patients
Fort Wayne Orthopaedics LLC Physician Assistant CurrentSince Oct 23, 2014 Accepting new patients
Community Physicians of Indiana Inc CurrentSince Jun 10, 2016 Accepting new patients
Major Hospital Past Accepting new patients

Locations

5819 Reliable Pkwy
Chicago, IL 60686

10412 Allisonville Rd
Ste 100
Fishers, IN 46038
Phone (317) 572-2240

7601 W Jefferson Blvd
Fort Wayne, IN 46804
Phone 26043686864254

6626 E 75th St
Ste 500
Indianapolis, IN 46250
Phone (317) 621-7547

7930 N Shadeland Ave
Indianapolis, IN 46250
Phone (317) 621-6725

7120 Clearvista Dr
Ste 4000
Indianapolis, IN 46256
Phone (317) 621-7444

Interoperability endpoints

  • Direct secure messaging: amazanowski126647@ecommunitydirect.com

Organizations & group practices 4

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": "1409788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782777600000",
    "number": "1548661986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6626 E 75TH ST STE 500",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462502890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10412 ALLISONVILLE RD STE 100",
            "city": "FISHERS",
            "state": "IN",
            "postal_code": "460382030",
            "telephone_number": "317-572-2240",
            "fax_number": "317-572-2235"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7930 N Shadeland Ave",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462502041",
            "country_code": "US",
            "telephone_number": "317-621-6725",
            "fax_number": "317-621-4545",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAZANOWSKI",
        "first_name": "EMILY",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-04",
        "last_updated": "2026-06-30",
        "certification_date": "2026-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IN",
            "license": "10001757A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000899969",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "OPR",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300005118",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "amazanowski126647@eCommunityDirect.com",
            "affiliation": "Y",
            "affiliationName": "Community Physicians of Indiana Inc",
            "address_1": "7930 N Shadeland Ave",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "462502041",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fishers, IN

Sources for this page

Verify at the official NPI Registry.