NPIMap

Individual provider Active NPI

Andrew David Dick, M.D.

  • Family Medicine Physician
  • Greenwood, IN
National Provider Identifier
1679570956
Registry record updated Jan 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
01032061 Issued in IN
Practice address
701 E County Line Rd
Suite 101
Greenwood, IN 46143-1070
Phone
(317) 883-4736
Fax
(317) 885-2869
NPI assigned
Jul 1, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 01032061 IN Primary

Addresses

Primary practice location

701 E County Line Rd
Suite 101
Greenwood, IN 46143-1070

Mailing address

701 E County Line Rd
Suite 101
Greenwood, IN 46143-1070
Phone (317) 883-4736

Other identifiers 1

IdentifierTypeStateIssuer
100073860MedicaidIN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address direct.indianainternalmedicine@ccme.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100104000484 IN Practitioner - Family Practice 4789612870 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Indiana University School of Medicine, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
St Francis Medical Group LLCGroup PAC ID 7012067697, 113 clinicians
Indiana Internal Medicine Consultants LLCGroup PAC ID 7911899489, 43 clinicians

Practice addresses (Care Compare)

701 E County Line Rd
Suite 101
Greenwood, IN 46143-1070
Phone (317) 885-2860

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01032061INMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Indiana Internal Medicine Consultants, LLC. Family Medicine CurrentSince Oct 1, 2012 Accepting new patients
St Francis Medical Group LLC CurrentSince Oct 1, 2012 Accepting new patients
St. Francis Medical Group, LLC Family Medicine CurrentSince Oct 1, 2012 Accepting new patients
Major Hospital Past Accepting new patients
St. Francis Hospital and Health Centers Past Accepting new patients

Locations

701 E County Line Rd
Ste 301
Greenwood, IN 46143
Phone (317) 883-4736

701 E County Line Rd
Ste 101
Greenwood, IN 46143
Phone (317) 885-2860

Interoperability endpoints

  • Direct secure messaging: direct.indianainternalmedicine@ccme.com

Organizations & group practices 5

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 9

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": "1120176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642032000000",
    "number": "1679570956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 E COUNTY LINE RD",
            "address_2": "SUITE 101",
            "city": "GREENWOOD",
            "state": "IN",
            "postal_code": "461431070",
            "telephone_number": "317-883-4736",
            "fax_number": "317-885-2869"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 E COUNTY LINE RD",
            "address_2": "SUITE 101",
            "city": "GREENWOOD",
            "state": "IN",
            "postal_code": "461431070",
            "telephone_number": "317-883-4736",
            "fax_number": "317-885-2869"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DICK",
        "first_name": "ANDREW",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-01",
        "last_updated": "2022-01-13",
        "certification_date": "2022-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01032061",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100073860",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "direct.indianainternalmedicine@ccme.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "701 E County Line Rd",
            "address_2": "Suite 101",
            "city": "Greenwood",
            "state": "IN",
            "country_code": "US",
            "postal_code": "461431070",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Greenwood, IN

Sources for this page

Verify at the official NPI Registry.