Active NPI
Heather Lynn Misra, MD
- Pulmonary Disease Physician
- Indianapolis, IN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pulmonary Disease Physician
- License
- 01060694A
- Practice address
- 8330 Naab Rd Ste 340
Indianapolis, IN 46260-2279 - Phone
- (317) 338-5100
- NPI assigned
- Aug 10, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pulmonary Disease Physician | 207RP1001X | 01060694A | IN | Primary |
| Critical Care Medicine (Internal Medicine) Physician | 207RC0200X | 01060694A | IN |
Addresses
Primary practice location
8330 Naab Rd Ste 340
Indianapolis, IN 46260-2279
Mailing address
10330 N Meridian St # 300
Indianapolis, IN 46290-1024
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200514960 | Medicaid | IN |
Other names 1
- Heather Lynn Wallace
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Pulmonary Disease
- Education
- Northeastern Ohio University College of Medicine, 1999
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2001 W 86TH St
Indianapolis, IN 46260-1902
Phone (317) 338-2345
250 W 96TH St
Suite 520
Indianapolis, IN 46260-1317
8433 Harcourt Rd
Suite 100
Indianapolis, IN 46260-2193
Phone (317) 583-7600
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01060694A | IN | MD | Critical Care Medicine (Internal Medicine) Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St. Vincent Medical Group, Inc. | Current | Accepting new patients | |
| St. Vincent Medical Group, Inc. | Current | Accepting new patients | |
| Respiratory & Critical Care Consultants P C | Critical Care Medicine | Past | Accepting new patients |
| Major Hospital | Past | Accepting new patients |
Locations
13500 N Meridian St
Carmel, IN 46032
Phone (317) 573-7000
8433 Harcourt Rd
Ste 100
Indianapolis, IN 46260
Phone (317) 583-7702
8333 Naab Rd
Ste 250
Indianapolis, IN 46260
Phone (317) 338-5100
2010 W 86th St
Ste 111
Indianapolis, IN 46260
Phone (317) 415-6580
8330 Naab Rd
Ste 340
Indianapolis, IN 46260
Phone (317) 338-5100
Interoperability endpoints
- heather.misra.1@7598.direct.athenahealth.com
Organizations & group practices 4
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.
-
- Orthopaedic Surgery Physician
- Winchester, IN
- NPI 1144513375
-
- Internal Medicine Physician
- Carmel, IN
- NPI 1811881527
-
- General Acute Care Hospital
- Shelbyville, IN
- NPI 1174555692
-
- Pulmonary Disease Physician
- Indianapolis, IN
- NPI 1801845086
Critical Care Medicine
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Danville, IN
- NPI 1669475950
-
- General Acute Care Hospital
- Kokomo, IN
- NPI 1780625442
-
- General Acute Care Hospital
- Indianapolis, IN
- NPI 1306898960
-
- General Acute Care Hospital
- Avon, IN
- NPI 1851833230
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1123632000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1484179200000",
"number": "1639171671",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10330 N MERIDIAN ST # 300",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462901024"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8330 NAAB RD STE 340",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462602279",
"telephone_number": "317-338-5100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MISRA",
"first_name": "HEATHER",
"middle_name": "LYNN",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-08-10",
"last_updated": "2017-01-12",
"status": "A"
},
"taxonomies": [
{
"code": "207RP1001X",
"taxonomy_group": "",
"desc": "Internal Medicine, Pulmonary Disease",
"state": "IN",
"license": "01060694A",
"primary": true
},
{
"code": "207RC0200X",
"taxonomy_group": "",
"desc": "Internal Medicine, Critical Care Medicine",
"state": "IN",
"license": "01060694A",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200514960",
"state": "IN"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "HEATHER",
"last_name": "WALLACE",
"middle_name": "LYNN",
"credential": "MD",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Indianapolis, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.