Individual provider Active NPI

Leilani Saum Mullis, MD

  • Anesthesiology Physician
  • Indianapolis, IN
National Provider Identifier
1669639084
Registry record updated Dec 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
01066821A Issued in IN
Practice address
720 Eskenazi Ave
Eskenazi Health Anesthesia - Second Floor Hospital
Indianapolis, IN 46202-5166
Phone
(317) 880-5386
Fax
(317) 880-0488
NPI assigned
May 22, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 01066821A IN Primary
Student in an Organized Health Care Education/Training Program 390200000X 11013098A IN

Addresses

Primary practice location

720 Eskenazi Ave
Eskenazi Health Anesthesia - Second Floor Hospital
Indianapolis, IN 46202-5166

Mailing address

720 Eskenazi Ave
Eskenazi Health Anesthesia - Second Floor Hospital
Indianapolis, IN 46202-5166
Phone (317) 880-5386

Other identifiers 1

IdentifierTypeStateIssuer
000000626645OtherINANTHEM PTAN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address lmullis13471@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
I20091006000627 IN Practitioner - Anesthesiology 6305982265 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
University of North Carolina at Chapel Hill School of Medicine, 2003
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

  • Eskenazi Health Hospital, Indianapolis, IN, CCN 150024

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01066821AINMDAnesthesiology Physician
11013098AINMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Wishard Anesthesia Group, LLC Anesthesiology CurrentSince Sep 15, 2009 Accepting new patients
Iu Health Medical Group, LLC CurrentSince Jan 1, 2025 Accepting new patients

Locations

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

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

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

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

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": "1211414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733270400000",
    "number": "1669639084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 ESKENAZI AVE",
            "address_2": "ESKENAZI HEALTH ANESTHESIA - SECOND FLOOR HOSPITAL",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462025166",
            "telephone_number": "317-880-5386",
            "fax_number": "317-880-0488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 ESKENAZI AVE",
            "address_2": "ESKENAZI HEALTH ANESTHESIA - SECOND FLOOR HOSPITAL",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462025166",
            "telephone_number": "317-880-5386",
            "fax_number": "317-880-0488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULLIS",
        "first_name": "LEILANI",
        "middle_name": "SAUM",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-22",
        "last_updated": "2024-12-04",
        "certification_date": "2024-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IN",
            "license": "01066821A",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "IN",
            "license": "11013098A",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM PTAN",
            "identifier": "000000626645",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lmullis13471@direct.eskenazihealth.edu",
            "affiliation": "N",
            "address_1": "720 Eskenazi Ave",
            "address_2": "Eskenazi Health Anesthesia - Second Floor Hospital",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "462025166",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.