NPIMap

Individual provider Active NPI

Jeffrey P Kyrouac, MD

  • Internal Medicine Physician
  • Indianapolis, IN
National Provider Identifier
1639186703
Registry record updated Jul 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
01070436A Issued in IN
Practice address
8433 Harcourt Rd Ste 200
Indianapolis, IN 46260-2195
Phone
(317) 338-7800
NPI assigned
Aug 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 01070436A IN Primary

Addresses

Primary practice location

8433 Harcourt Rd Ste 200
Indianapolis, IN 46260-2195

Mailing address

8433 Harcourt Rd Ste 200
Indianapolis, IN 46260-2195

Other identifiers 2

IdentifierTypeStateIssuer
1639186703OtherILNPI
010042898OtherILRAILROAD

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jeffrey.kyrouac.1@7598.direct.athenahealth.com St. Vincent Medical Group, Inc.

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111208000306 IN Practitioner - Internal Medicine 0648336040 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Southern Illinois University School of Medicine, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Vincent Medical Group IncGroup PAC ID 7012047640, 728 clinicians

Practice addresses (Care Compare)

250 W 96TH St
Suite 520
Indianapolis, IN 46260-1317

8433 Harcourt Rd
Suite 100
Indianapolis, IN 46260-2193
Phone (317) 583-7600

8433 Harcourt Rd
Suite 200
Indianapolis, IN 46260-2195
Phone (317) 338-7800

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01070436AINMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St. Vincent Medical Group, Inc. Internal Medicine Current Accepting new patients
St. Vincent Medical Group, Inc. Internal Medicine CurrentSince Dec 12, 2011 Accepting new patients
St. Vincent Medical Group, Inc. CurrentSince Dec 12, 2011 Accepting new patients
St Vincent Medical Group Inc Past Accepting new patients

Locations

8433 Harcourt Rd
Ste 100
Indianapolis, IN 46260
Phone (317) 583-7702

8840 Commerce Park Pl
Ste E
Indianapolis, IN 46268
Phone (317) 583-4420

8433 Harcourt Rd
Ste 200
Indianapolis, IN 46260
Phone (317) 338-4692

Interoperability endpoints

  • Direct secure messaging: jeffrey.kyrouac.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.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1154476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658102400000",
    "number": "1639186703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8433 HARCOURT RD STE 200",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462602195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8433 HARCOURT RD STE 200",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462602195",
            "telephone_number": "317-338-7800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KYROUAC",
        "first_name": "JEFFREY",
        "middle_name": "P",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-02",
        "last_updated": "2022-07-18",
        "certification_date": "2022-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IN",
            "license": "01070436A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1639186703",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD",
            "identifier": "010042898",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jeffrey.kyrouac.1@7598.direct.athenahealth.com",
            "affiliation": "Y",
            "affiliationName": "St. Vincent Medical Group, Inc.",
            "address_1": "8433 Harcourt Rd Ste 200",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "462602195",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.