Individual provider Active NPI

Leonid Gorelik, MD

  • Anesthesiology Physician
  • Indianapolis, IN
National Provider Identifier
1700871050
Registry record updated Dec 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
01088357A Issued in IN
Practice address
8075 N Shadeland Ave
Indianapolis, IN 46250-2693
Phone
(317) 887-7000
NPI assigned
Sep 13, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 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 4301085309 MI
Anesthesiology Physician 207L00000X 01088357A IN Primary

Addresses

Primary practice location

8075 N Shadeland Ave
Indianapolis, IN 46250-2693

Mailing address

1200 E Michigan Ave
Suite 370
Lansing, MI 48912-1800
Phone (517) 484-4451

Other practice location 1

1200 E Michigan Ave
Suite 370
Lansing, MI 48912-1800
Phone (517) 484-4451

Other identifiers 1

IdentifierTypeStateIssuer
104739656MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, IN2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20050616001093 MI Practitioner - Anesthesiology 1850335100 Reassigns benefits to 1 organization
I20220822002113 IN Practitioner - Anesthesiology 1850335100 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Anesthesia Associates, PCGroup PAC ID 5991754145, 53 clinicians
Community Physicians of Indiana IncGroup PAC ID 1759416662, 1,569 clinicians

Practice addresses (Care Compare)

8040 Clearvista Pkwy
Indianapolis, IN 46256-5630
Phone (317) 621-2000

8075 N Shadeland Ave
Indiana Heart Hospital
Indianapolis, IN 46250-2693
Phone (317) 621-8000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301085309MIMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Community Physicians of Indiana Inc CurrentSince Jan 6, 2025 Accepting new patients
Community Physicians of Indiana Inc CurrentSince Jan 6, 2025 Accepting new patients
Edward W. Sparrow Hospital Association Anesthesiology CurrentSince May 27, 2020 Accepting new patients
Community Anesthesia Associates, PC Anesthesiology CurrentSince Aug 18, 2022 Accepting new patients

Locations

8175 Reliable Pkwy
Chicago, IL 60686

5819 Reliable Pkwy
Chicago, IL 60686

8075 N Shadeland Ave
Indianapolis, IN 46250
Phone (317) 621-8000

8040 Clearvista Pkwy
Indianapolis, IN 46256
Phone (317) 254-5740

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

1215 E Michigan Ave
Lansing, MI 48912
Phone (517) 336-8080

Organizations & group practices 4

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": "1126569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734566400000",
    "number": "1700871050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 E MICHIGAN AVE",
            "address_2": "SUITE 370",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489121800",
            "telephone_number": "517-484-4451",
            "fax_number": "517-484-0291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8075 N SHADELAND AVE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462502693",
            "telephone_number": "317-887-7000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1200 E Michigan Ave",
            "address_2": "Suite 370",
            "address_purpose": "LOCATION",
            "city": "Lansing",
            "state": "MI",
            "postal_code": "489121800",
            "country_code": "US",
            "telephone_number": "517-484-4451",
            "fax_number": "517-484-0291",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GORELIK",
        "first_name": "LEONID",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-13",
        "last_updated": "2024-12-19",
        "certification_date": "2024-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MI",
            "license": "4301085309",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IN",
            "license": "01088357A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104739656",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.