Individual provider Active NPI

Manahil Mustafa Elamin Mustafa, MBBS

  • Pediatric Endocrinology Physician
  • Indianapolis, IN
National Provider Identifier
1619504057
Registry record updated Aug 19, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Endocrinology PhysicianTaxonomy code 2080P0205X
License
01090425A Issued in IN
Practice address
575 Riley Hospital Dr
Indianapolis, IN 46202-5272
Phone
(317) 944-3889
Fax
(317) 944-3882
NPI assigned
Mar 25, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 19, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Endocrinology Physician 2080P0205X 01090425A IN Primary

Addresses

Primary practice location

575 Riley Hospital Dr
Indianapolis, IN 46202-5272

Mailing address

PO Box 719094
Chicago, IL 60677-9318
Phone (317) 777-6435

Other identifiers 1

IdentifierTypeStateIssuer
300076012MedicaidIN

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
I20230530002109 IN Order and Referring Only - EndocrinologyPractitioner - Endocrinology 7315304706

Care Compare profile

Medicare Care Compare
Specialty
Endocrinology
Education
Other, 2009
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

500 W Jefferson St
Louisville, KY 40202-2823

705 Riley Hospital Dr
Indianapolis, IN 46202-5109

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
01090425AINMDPediatric Endocrinology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Iu Health Medical Group Riley Specialists, LLC Single Specialty 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1585094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787097600000",
    "number": "1619504057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 719094",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606779318",
            "telephone_number": "317-777-6435",
            "fax_number": "317-777-6644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "575 RILEY HOSPITAL DR",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462025272",
            "telephone_number": "317-944-3889",
            "fax_number": "317-944-3882"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUSTAFA",
        "first_name": "MANAHIL",
        "middle_name": "MUSTAFA ELAMIN",
        "credential": "MBBS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-03-25",
        "last_updated": "2026-08-19",
        "certification_date": "2026-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0205X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Endocrinology",
            "state": "IN",
            "license": "01090425A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300076012",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.