Individual provider Active NPI

Manige Konig, MD

  • Endocrinology, Diabetes & Metabolism Physician
  • Indianapolis, IN
National Provider Identifier
1629231584
Registry record updated Jun 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
01073803A Issued in IN
Practice address
8424 Naab Rd BLDG 1
Suite #1-B
Indianapolis, IN 46260-5918
Phone
(317) 338-7490
NPI assigned
Jul 9, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 01073803A IN
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 01073803A IN Primary

Addresses

Primary practice location

8424 Naab Rd BLDG 1
Suite #1-B
Indianapolis, IN 46260-5918

Mailing address

250 N Shadeland Ave
Indianapolis, IN 46219-4959

Other identifiers 1

IdentifierTypeStateIssuer
201230010MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140722002138 IN Practitioner - EndocrinologyPractitioner - Internal Medicine 0042453169 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01073803AINMDEndocrinology, Diabetes & Metabolism Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Medical Diagnostic Associates, Inc. Internal Medicine CurrentSince Apr 1, 2019 Accepting new patients
St. Vincent Hospital & Health Care Center, Inc. CurrentSince Jul 9, 2017 Accepting new patients
Indiana University Health Care Associates, Inc CurrentSince Jul 1, 2019 Accepting new patients
St. Vincent Hospital & Health Care Center, Inc. CurrentSince Jul 9, 2017 Accepting new patients
Major Hospital Past Accepting new patients

Locations

7301 Solutions Ctr
Chicago, IL 60677

5208 Reliable Pkwy
Chicago, IL 60686

720 Eskenazi Ave
Indianapolis, IN 46202
Phone (317) 880-0000

550 University Blvd
Indianapolis, IN 46202
Phone (217) 274-5000

250 N Shadeland Ave
Indianapolis, IN 46219
Phone (317) 948-9174

1701 N Senate Blvd
Bldg C6
Indianapolis, IN 46202
Phone (913) 962-2000

8401 Harcourt Rd
Ste 302
Indianapolis, IN 46260
Phone (317) 338-4600

Organizations & group practices 5

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": "1215561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560470400000",
    "number": "1629231584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 N SHADELAND AVE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462194959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8424 NAAB RD BLDG 1",
            "address_2": "SUITE #1-B",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462605918",
            "telephone_number": "317-338-7490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KONIG",
        "first_name": "MANIGE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-09",
        "last_updated": "2019-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IN",
            "license": "01073803A",
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "IN",
            "license": "01073803A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201230010",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.