Individual provider Active NPI

Bryan R Mayol, MD

  • Sports Medicine (Family Medicine) Physician
  • Fishers, IN
National Provider Identifier
1669484333
Registry record updated Nov 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X
License
01069552A Issued in IN
Practice address
13100 136TH Street
Suite 2000
Fishers, IN 46037-9440
Phone
(317) 688-5980
Fax
(317) 688-3222
NPI assigned
Aug 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2014

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 01049047 IN
Family Medicine Physician 207Q00000X 01069552A IN
Sports Medicine (Family Medicine) Physician 207QS0010X 01069552A IN Primary

Addresses

Primary practice location

13100 136TH Street
Suite 2000
Fishers, IN 46037-9440

Mailing address

250 N Shadeland Ave
Ste 130
Indianapolis, IN 46219-4959

Other identifiers 1

IdentifierTypeStateIssuer
200265700MedicaidIN

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
I20051121000306 IN Practitioner - Sports MedicinePractitioner - Family Practice 0840219788 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Sports MedicineAlso: Family Practice
Education
Indiana University School of Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Iu Health Medical Group LLCGroup PAC ID 9638617913, 4,382 clinicians

Practice addresses (Care Compare)

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

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
53.91 of 100Reported as individual
Quality
70.75
Promoting interoperability
0
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
45078TNMDPharmacist
01049047INMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Iu Health Medical Group, LLC CurrentSince Jul 1, 2025 Accepting new patients
University Family Physicians, Inc. CurrentSince Sep 19, 2012 Accepting new patients
Indiana University Health Care Associates, Inc CurrentSince Aug 15, 2011 Accepting new patients
University Family Physicians, Inc. Family Medicine CurrentSince Sep 19, 2012 Accepting new patients
Major Hospital Past Accepting new patients
University Medical Diagnostic Associates, Inc. Past Accepting new patients

Locations

5208 Reliable Pkwy
Chicago, IL 60686

7216 Solutions Ctr
Chicago, IL 60677

201 Pennsylvania Pkwy
Carmel, IN 46280
Phone (317) 817-1254

11725 Illinois St
Carmel, IN 46032
Phone (317) 617-4808

13100 E 136th St
Fishers, IN 46037
Phone (317) 678-2000

13100 E 136th St
Ste 2000
Fishers, IN 46037
Phone (317) 688-5980

8450 Northwest Blvd
Indianapolis, IN 46278

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

250 N Shadeland Ave
Ste 130
Indianapolis, IN 46219
Phone (317) 962-4836

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

1801 Senate Blvd
Ste 200
Indianapolis, IN 46202
Phone (317) 917-4183

1520 N Senate Ave
Indianapolis, IN 46202
Phone (317) 962-0857

1701 N Senate Blvd
Bldg C6
Indianapolis, IN 46202
Phone (913) 962-2000

3600 W Bethel Ave
Muncie, IN 47304
Phone (765) 213-3870

Interoperability endpoints

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

Organizations & group practices 6

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": "1155340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1416268800000",
    "number": "1669484333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 N SHADELAND AVE",
            "address_2": "STE 130",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462194959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13100 136TH STREET",
            "address_2": "SUITE 2000",
            "city": "FISHERS",
            "state": "IN",
            "postal_code": "460379440",
            "telephone_number": "317-688-5980",
            "fax_number": "317-688-3222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAYOL",
        "first_name": "BRYAN",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-12",
        "last_updated": "2014-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01049047",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01069552A",
            "primary": false
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "IN",
            "license": "01069552A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200265700",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fishers, IN

Sources for this page

Verify at the official NPI Registry.