Individual provider Active NPI

Damon Fu

  • Gastroenterology Physician
  • Indianapolis, IN
National Provider Identifier
1689018822
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
01082586A Issued in IN
Practice address
1400 N Ritter Ave Ste 370
Indianapolis, IN 46219-3098
Phone
(317) 355-1144
Fax
(317) 355-1155
NPI assigned
Apr 18, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2023

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 57.022612 OH
Gastroenterology Physician 207RG0100X 036.140358 IL
Gastroenterology Physician 207RG0100X 01082586A IN Primary

Addresses

Primary practice location

1400 N Ritter Ave Ste 370
Indianapolis, IN 46219-3098

Mailing address

6626 E 75TH St Ste 500
Indianapolis, IN 46250-2890

Other practice location 1

627 S Wood St
room 833
Chicago, IL 60612-3821
Phone (312) 964-0393

Other identifiers 1

IdentifierTypeStateIssuer
300028282MedicaidIN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address dfu338655@eCommunityDirect.com Community Physicians of Indiana Inc

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
I20190807002037 IN Practitioner - Gastroenterology 2062654502 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
University of Cincinnati College of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Physicians of Indiana IncGroup PAC ID 1759416662, 1,569 clinicians

Practice addresses (Care Compare)

7950 N Shadeland Ave
Suite 350
Indianapolis, IN 46250-2699
Phone (317) 621-6900

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy67
Upper gastrointestinal (GI) endoscopy for acid reflux95

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
57.022612OHMDInternal Medicine Physician
036.140358ILMDGastroenterology Physician
01082586AINMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Community Physicians of Indiana Inc Internal Medicine CurrentSince Sep 23, 2019 Accepting new patients
Community Physicians of Indiana Inc CurrentSince Sep 23, 2019 Accepting new patients
Major Hospital Past Accepting new patients

Locations

5819 Reliable Pkwy
Chicago, IL 60686

11911 N Meridian St
Ste 128
Carmel, IN 46032
Phone (317) 621-6730

7120 Clearvista Dr
Ste 4000
Indianapolis, IN 46256
Phone (317) 621-7444

6626 E 75th St
Ste 500
Indianapolis, IN 46250
Phone (317) 621-7547

7950 N Shadeland Ave
Ste 350
Indianapolis, IN 46250
Phone (317) 578-2600

7240 Shadeland Sta
Ste 300
Indianapolis, IN 46256
Phone (317) 621-6060

1400 N Ritter Ave
Ste 370
Indianapolis, IN 46219
Phone (317) 355-1144

7400 N Shadeland Ave
Ste 100
Indianapolis, IN 46250
Phone (317) 621-6900

Interoperability endpoints

  • Direct secure messaging: dfu338655@ecommunitydirect.com

Organizations & group practices 3

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": "1366243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1689018822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6626 E 75TH ST STE 500",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462502890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 N RITTER AVE STE 370",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462193098",
            "telephone_number": "317-355-1144",
            "fax_number": "317-355-1155"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "627 S Wood St",
            "address_2": "room 833",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606123821",
            "country_code": "US",
            "telephone_number": "312-964-0393",
            "fax_number": "312-864-9919",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FU",
        "first_name": "DAMON",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-04-18",
        "last_updated": "2023-11-27",
        "certification_date": "2020-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "57.022612",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "IL",
            "license": "036.140358",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "IN",
            "license": "01082586A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300028282",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dfu338655@eCommunityDirect.com",
            "affiliation": "Y",
            "affiliationName": "Community Physicians of Indiana Inc",
            "address_1": "7240 Shadeland Station",
            "address_2": "Suite 300",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "462563944",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.