Individual provider Active NPI

Melanie K Johannessohn

  • Pediatrics Physician
  • Indianapolis, IN
National Provider Identifier
1669430658
Registry record updated Sep 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
01045603A Issued in IN
Practice address
1001 W 10TH St
Indianapolis, IN 46202-2859
Phone
(317) 630-7979
Fax
(317) 630-2668
NPI assigned
May 2, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 01045603A IA
Pediatrics Physician 208000000X 01045603A IN Primary
Hospitalist Physician 208M00000X 01045603A IN

Addresses

Primary practice location

1001 W 10TH St
Indianapolis, IN 46202-2859

Mailing address

PO Box 637764
Cincinnati, OH 45263-7764
Phone (317) 880-3939

Other practice location 1

720 Eskenazi Ave
Indianapolis, IN 46202-5187
Phone (317) 880-7666

Other identifiers 1

IdentifierTypeStateIssuer
200002280MedicaidIN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mjohannessohn13373@direct.eskenazihealth.edu

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
I20051028000709 IN Practitioner - Internal MedicinePractitioner - Pediatric Medicine 3375560378 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Pediatric Medicine
Education
Indiana University School of Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eskenazi Medical Group IncGroup PAC ID 4284546813, 134 clinicians

Practice addresses (Care Compare)

720 Eskenazi Ave
Indianapolis, IN 46202-5187
Phone (317) 880-7666

720 Eskenazi Ave FL
5 OB/GYN Clinic
Indianapolis, IN 46202-5189
Phone (317) 880-6000

Hospital & facility affiliations

  • Eskenazi Health Hospital, Indianapolis, IN, CCN 150024

Merit-based Incentive Payment System (MIPS)

Final score
98.69 of 100Reported as group
Quality
80.42
Promoting interoperability
100
Improvement activities
40
Cost
81.89

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01045603AIAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Eskenazi Medical Group Inc CurrentSince Oct 3, 2005 Accepting new patients
The Health and Hospital Corporation of Marion County CurrentSince Feb 28, 2010 Accepting new patients
Eskenazi Medical Group Inc Internal Medicine CurrentSince Oct 3, 2005 Accepting new patients
University Medical Diagnostic Associates, Inc. Internal Medicine Past Accepting new patients

Locations

6940 Michigan Rd
Ste 140
Indianapolis, IN 46268
Phone (317) 266-2901

720 Eskenazi Ave
Fl 2
Indianapolis, IN 46202
Phone (317) 278-5316

720 Eskenazi Ave
Bldg 5TH
Indianapolis, IN 46202
Phone (317) 880-3818

1002 Wishard Blvd
Fl 4
Indianapolis, IN 46202
Phone (317) 692-2323

2732 W Michigan St
Indianapolis, IN 46222
Phone (317) 554-4600

2505 N Arlington Ave
Indianapolis, IN 46218
Phone (317) 554-5200

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

2700 Martin Luther King Jr St
Indianapolis, IN 46208
Phone (317) 931-4300

5515 W 38th St
Indianapolis, IN 46254
Phone (317) 880-3838

9443 E 38th St
Indianapolis, IN 46235
Phone (317) 890-2100

720 Eskenazi Ave
Fl 5
Indianapolis, IN 46202
Phone (317) 880-6000

1700 N Illinois St
Indianapolis, IN 46202
Phone (317) 554-5700

3840 N Sherman Dr
Indianapolis, IN 46226
Phone (317) 541-3400

1001 W 10th St
Indianapolis, IN 46202
Phone (317) 630-6175

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 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": "1146528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758499200000",
    "number": "1669430658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 637764",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452637764",
            "telephone_number": "317-880-3939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 W 10TH ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462022859",
            "telephone_number": "317-630-7979",
            "fax_number": "317-630-2668"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "720 Eskenazi Ave",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462025187",
            "country_code": "US",
            "telephone_number": "317-880-7666",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHANNESSOHN",
        "first_name": "MELANIE",
        "middle_name": "K",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-02",
        "last_updated": "2025-09-22",
        "certification_date": "2025-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IA",
            "license": "01045603A",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IN",
            "license": "01045603A",
            "primary": true
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "IN",
            "license": "01045603A",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200002280",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mjohannessohn13373@direct.eskenazihealth.edu",
            "affiliation": "N",
            "address_1": "720 Eskenazi Ave",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "462025187",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.