Individual provider Active NPI

Eldred Hugh Macdonell Jr., MD

  • Gastroenterology Physician
  • Indianapolis, IN
National Provider Identifier
1629045042
Registry record updated Jan 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
01042438A Issued in IN
Practice address
1400 N. Ritter Ave.
Suite 370
Indianapolis, IN 46219-3098
Phone
(317) 355-1144
Fax
(317) 355-1155
NPI assigned
Mar 3, 2006
Last updated
Jan 5, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 01042438A IN Primary

Addresses

Primary practice location

1400 N. Ritter Ave.
Suite 370
Indianapolis, IN 46219-3098

Mailing address

12031 Edgefield Dr
Fishers, IN 46037-3826

Other identifiers 4

IdentifierTypeStateIssuer
000000793547OtherINANTHEM
100474160MedicaidIN
100474160AMedicaidIN
P01157058OtherINMEDICARE RAILROAD

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address emacdonell30212@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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101029000315 IN Practitioner - Gastroenterology 0446303994 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01042438AINMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Community Physicians of Indiana Inc CurrentSince Dec 31, 2012 Accepting new patients
Community Physicians of Indiana Inc CurrentSince Dec 31, 2012 Accepting new patients

Locations

5819 Reliable Pkwy
Chicago, IL 60686

1400 N Ritter Ave
Ste 370
Indianapolis, IN 46219
Phone (317) 355-1144

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

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

7950 N Shadeland Ave
Ste 350
Indianapolis, IN 46250
Phone (317) 578-2600

Interoperability endpoints

  • Direct secure messaging: emacdonell30212@ecommunitydirect.com

Organizations & group practices 2

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": "1141344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704412800000",
    "number": "1629045042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12031 EDGEFIELD DR",
            "city": "FISHERS",
            "state": "IN",
            "postal_code": "460373826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 N. RITTER AVE.",
            "address_2": "SUITE 370",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462193098",
            "telephone_number": "317-355-1144",
            "fax_number": "317-355-1155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACDONELL",
        "first_name": "ELDRED",
        "middle_name": "HUGH",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-03",
        "last_updated": "2024-01-05",
        "certification_date": "2024-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "IN",
            "license": "01042438A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000793547",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100474160",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100474160A",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P01157058",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "emacdonell30212@eCommunityDirect.com",
            "affiliation": "Y",
            "affiliationName": "Community Physicians of Indiana Inc",
            "address_1": "1400 N. Ritter Ave.",
            "address_2": "Suite 370",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "462193098",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.