Individual provider Active NPI

Paul Ndekwe, M.D.

  • Anatomic Pathology & Clinical Pathology Physician
  • Indianapolis, IN
National Provider Identifier
1598101511
Registry record updated Jun 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
036145486 Issued in IL
Practice address
635 Barnhill Dr
Indianapolis, IN 46202
Phone
(317) 274-4806
NPI assigned
May 16, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 036145486 IL Primary

Addresses

Primary practice location

635 Barnhill Dr
Indianapolis, IN 46202

Mailing address

635 Barnhill Dr
Indianapolis, IN 46202-5126

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, IA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20180726003416 IL Practitioner - Pathology 8224327929 Reassigns benefits to 1 organization
I20191206001807 IA Practitioner - Pathology 8224327929 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Peoria Tazewell Pathology Group, S.C.Group PAC ID 1254228711, 17 clinicians

Practice addresses (Care Compare)

210 W Walnut St
Canton, IL 61520-2444
Phone (309) 647-5240

221 NE Glen Oak Ave
Peoria, IL 61636-0001
Phone (309) 672-4918

2701 17TH St
Rock Island, IL 61201-5351
Phone (309) 779-5286

4500 Utica Ridge Rd
Bettendorf, IA 52722-1626
Phone (563) 742-2724

5409 N Knoxville Ave
Peoria, IL 61614-5069
Phone (309) 691-1000

Hospital & facility affiliations

  • Carle Health Methodist Hospital Hospital, Peoria, IL, CCN 140209
  • Memorial Hospital Hospital, Carthage, IL, CCN 141305
  • Carle Health Pekin Hospital Hospital, Pekin, IL, CCN 140120
  • Carle Health Proctor Hospital Hospital, Peoria, IL, CCN 140013
  • Graham Hospital Association Hospital, Canton, IL, CCN 141356

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
St Luke'S Methodist Hospital Current Accepting new patients
Nourishing Direction Inc Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: pndekwe624059@direct.unitypoint.org

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 and National Provider Directory roles.

Hospital & facility affiliations 6

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": "1368662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530057600000",
    "number": "1598101511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "635 BARNHILL DR",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462025126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "635 BARNHILL DR",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "46202",
            "telephone_number": "317-274-4806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NDEKWE",
        "first_name": "PAUL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-05-16",
        "last_updated": "2018-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "IL",
            "license": "036145486",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.