Individual provider Active NPI

Kathryn Elizabeth Niemeyer, M.D.

  • Diagnostic Radiology Physician
  • Maywood, IL
National Provider Identifier
1649567330
Registry record updated Jul 30, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
2011018966 Issued in MO
Practice address
2160 S 1St Ave
Radiology Department
Maywood, IL 60153-3328
Phone
(708) 216-1084
NPI assigned
Jul 1, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 30, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 2011018966 MO Primary

Addresses

Primary practice location

2160 S 1St Ave
Radiology Department
Maywood, IL 60153-3328

Mailing address

2160 S 1St Ave
Radiology Department
Maywood, IL 60153-3328

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
I20160718000304 IN Practitioner - Diagnostic Radiology 8820390321 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Washington University School of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Iu Health Medical Group LLCGroup PAC ID 9638617913, 4,382 clinicians
Indiana University Radiology Associates IncGroup PAC ID 7315922267, 213 clinicians

Practice addresses (Care Compare)

1701 N Senate Blvd
Indianapolis, IN 46202-1239
Phone (888) 484-3258

550 N University Blvd Room
Suite 0663
Indianapolis, IN 46202-5149

550 University Blvd
Indianapolis, IN 46202-5149
Phone (317) 948-7569

642 W Hospital Rd
Iu Health Paoli Hospital
Paoli, IN 47454-9672
Phone (812) 723-2811

8830 S Meridian St
Indianapolis, IN 46217-5029
Phone (317) 865-6675

Hospital & facility affiliations

  • Indiana University Health Hospital, Indianapolis, IN, CCN 150056
  • Indiana University Health Paoli Hospital Hospital, Paoli, IN, CCN 151306

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2011018966MOMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Iu Health Medical Group, LLC CurrentSince Oct 1, 2025 Accepting new patients
Indiana University Radiology Associates, Inc. Diagnostic Radiology CurrentSince Jul 1, 2016 Accepting new patients

Locations

5924 Reliable Pkwy
Chicago, IL 60686

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

1701 Senate Blvd
Indianapolis, IN 46202
Phone (317) 612-2754

1701 Senate Blvd
#C6
Indianapolis, IN 46202
Phone (317) 962-9000

Interoperability endpoints

  • Direct secure messaging: kniemeyer15455@direct.eskenazihealth.edu

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.

Hospital & facility affiliations 2

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": "1309478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343606400000",
    "number": "1649567330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2160 S 1ST AVE",
            "address_2": "RADIOLOGY DEPARTMENT",
            "city": "MAYWOOD",
            "state": "IL",
            "postal_code": "601533328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2160 S 1ST AVE",
            "address_2": "RADIOLOGY DEPARTMENT",
            "city": "MAYWOOD",
            "state": "IL",
            "postal_code": "601533328",
            "telephone_number": "708-216-1084"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIEMEYER",
        "first_name": "KATHRYN",
        "middle_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-07-01",
        "last_updated": "2012-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MO",
            "license": "2011018966",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maywood, IL

Sources for this page

Verify at the official NPI Registry.