Active NPI
David Nick Pagaduan
- Contractor
- Indianapolis, IN
National Provider Identifier
1700022746
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Contractor
- License
- 008095
- Practice address
- 5980 W 71St St
Ste 102
Indianapolis, IN 46278-2711 - Phone
- (317) 388-0800
- Fax
- (317) 388-0805
- NPI assigned
- Dec 22, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Contractor | 171W00000X | 008095 | CT | Primary |
| Contractor | 171W00000X | 030946 | NY |
Addresses
Primary practice location
5980 W 71St St
Ste 102
Indianapolis, IN 46278-2711
Mailing address
5980 W 71St St
Ste 102
Indianapolis, IN 46278-2711
Phone (317) 388-0800
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 008095 | CT | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Access Therapies,Inc | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Environmental Modification Occupational Therapist
- Indianapolis, IN
- NPI 1780013607
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1229904000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1229904000000",
"number": "1700022746",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5980 W 71ST ST",
"address_2": "STE 102",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462782711",
"telephone_number": "317-388-0800",
"fax_number": "317-388-0805"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5980 W 71ST ST",
"address_2": "STE 102",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462782711",
"telephone_number": "317-388-0800",
"fax_number": "317-388-0805"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PAGADUAN",
"first_name": "DAVID NICK",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-12-22",
"last_updated": "2008-12-22",
"status": "A"
},
"taxonomies": [
{
"code": "171W00000X",
"taxonomy_group": "",
"desc": "Contractor",
"state": "CT",
"license": "008095",
"primary": true
},
{
"code": "171W00000X",
"taxonomy_group": "",
"desc": "Contractor",
"state": "NY",
"license": "030946",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Indianapolis, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.