Individual provider Active NPI

Roberta A Hibbard, MD

  • Child Abuse Pediatrics Physician
  • Indianapolis, IN
National Provider Identifier
1649387473
Registry record updated Jan 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child Abuse Pediatrics PhysicianTaxonomy code 2080C0008X
License
01034240 Issued in IN
Practice address
1001 W 10TH St
B2100
Indianapolis, IN 46202-2859
Phone
(317) 630-7865
Fax
(317) 630-2587
NPI assigned
Aug 25, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 01034240 IN
Child Abuse Pediatrics Physician 2080C0008X 01034240 IN Primary

Addresses

Primary practice location

1001 W 10TH St
B2100
Indianapolis, IN 46202-2859

Mailing address

PO Box 1026
Indianapolis, IN 46206-1026
Phone (317) 274-1201

Other identifiers 1

IdentifierTypeStateIssuer
100238580MedicaidIN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address rhibbard@direct.iuhealth.org

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
I20110301000990 IN Practitioner - Pediatric Medicine 4688855299 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01034240INMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Pediatric Associates, Inc. Pediatrics CurrentSince Jan 26, 2011 Accepting new patients
Major Hospital Past Accepting new patients

Locations

705 Riley Hospital Dr
#3038C
Indianapolis, IN 46202
Phone (317) 274-2617

705 Riley Hospital Dr
Indianapolis, IN 46202
Phone (317) 274-4779

1001 W 10th St
Ste B2100
Indianapolis, IN 46202

1001 W 10th St
#B2100
Indianapolis, IN 46202
Phone (317) 630-7865

Interoperability endpoints

  • Direct secure messaging: rhibbard@direct.iuhealth.org

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1156464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610496000000",
    "number": "1649387473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1026",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462061026",
            "telephone_number": "317-274-1201",
            "fax_number": "317-278-9905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 W 10TH ST",
            "address_2": "B2100",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462022859",
            "telephone_number": "317-630-7865",
            "fax_number": "317-630-2587"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HIBBARD",
        "first_name": "ROBERTA",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-25",
        "last_updated": "2021-01-13",
        "certification_date": "2021-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IN",
            "license": "01034240",
            "primary": false
        },
        {
            "code": "2080C0008X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Child Abuse Pediatrics",
            "state": "IN",
            "license": "01034240",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100238580",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rhibbard@direct.iuhealth.org",
            "affiliation": "N",
            "address_1": "1001 W 10th St",
            "address_2": "B2100",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "462022859",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.