Individual provider Active NPI

Nathan M Stadem

  • Student in an Organized Health Care Education/Training Program
  • Indianapolis, IN
National Provider Identifier
1619770484
Registry record updated May 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
350 W 14TH St
Indianapolis, IN 46202-2369
Phone
(317) 274-0267
NPI assigned
Mar 28, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 14, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

350 W 14TH St
Indianapolis, IN 46202-2369

Mailing address

25248 475TH Ave
Baltic, SD 57003-5944
Phone (605) 610-7559

Other practice location 1

25248 475th Ave
Baltic, SD 57003-5944
Phone (605) 610-7559

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
I20260618001837 IN Order and Referring Only - AnesthesiologyPractitioner - Anesthesiology 2062984222

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1743120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778716800000",
    "number": "1619770484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25248 475TH AVE",
            "city": "BALTIC",
            "state": "SD",
            "postal_code": "570035944",
            "telephone_number": "605-610-7559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 W 14TH ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462022369",
            "telephone_number": "317-274-0267"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "25248 475th Ave",
            "address_purpose": "LOCATION",
            "city": "Baltic",
            "state": "SD",
            "postal_code": "570035944",
            "country_code": "US",
            "telephone_number": "605-610-7559",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STADEM",
        "first_name": "NATHAN",
        "middle_name": "M",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-03-28",
        "last_updated": "2026-05-14",
        "certification_date": "2026-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.