NPIMap

Individual provider Active NPI

Matthew R Galvin, MD

  • Child & Adolescent Psychiatry Physician
  • Indianapolis, IN
National Provider Identifier
1578547642
Registry record updated Dec 28, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
License
01028956A Issued in IN
Practice address
210 E 91St St
Suite C
Indianapolis, IN 46240-1569
Phone
(317) 844-0055
Fax
(317) 571-5040
NPI assigned
Dec 2, 2005
Last updated
Dec 28, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 01028956A IN
Child & Adolescent Psychiatry Physician 2084P0804X 01028956A IN Primary

Addresses

Primary practice location

210 E 91St St
Suite C
Indianapolis, IN 46240-1569

Mailing address

210 E 91St St
Suite C
Indianapolis, IN 46240-1569

Other identifiers 1

IdentifierTypeStateIssuer
100098950MedicaidIN

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

Practice roles

OrganizationSpecialtyStatusNew patients
Major Hospital Past Accepting new patients
Christian Theological Seminary Psychiatry Past Accepting new patients
St. Vincent Hospital & Health Care Center, Inc. Psychiatry Past Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1133481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1325030400000",
    "number": "1578547642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 E 91ST ST",
            "address_2": "SUITE C",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462401569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 E 91ST ST",
            "address_2": "SUITE C",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462401569",
            "telephone_number": "317-844-0055",
            "fax_number": "317-571-5040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GALVIN",
        "first_name": "MATTHEW",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-02",
        "last_updated": "2011-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IN",
            "license": "01028956A",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "IN",
            "license": "01028956A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100098950",
            "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 Dec 28, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.