NPIMap

Individual provider Active NPI

Dmitry Michael Arbuck, M.D

  • Specialist
  • Indianapolis, IN
National Provider Identifier
1700872033
Registry record updated Jul 22, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
01044705 Issued in IN
Practice address
201 Pennsylvania Pkwy
Suite 200
Indianapolis, IN 46280-2301
Phone
(317) 805-5500
Fax
(317) 805-5501
NPI assigned
Sep 22, 2005
Last updated
Jul 22, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 01044705 IN Primary
Pain Medicine (Psychiatry & Neurology) Physician 2084P2900X 01044705A IN

Addresses

Primary practice location

201 Pennsylvania Pkwy
Suite 200
Indianapolis, IN 46280-2301

Mailing address

201 Pennsylvania Pkwy
Suite 200
Indianapolis, IN 46280-2301
Phone (317) 805-5500

Other identifiers 1

IdentifierTypeStateIssuer
200163070MedicaidIN

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
I20110616000241 IN Practitioner - Psychiatry 6507767522 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Indiana Polyclinic PCGroup PAC ID 6608016019, 6 clinicians

Practice addresses (Care Compare)

201 Pennsylvania Pkwy
Indianapolis, IN 46280-1393

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
23.84 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
79.45

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01044705INMDSpecialist
01044705AINMDPain Medicine (Psychiatry & Neurology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Indiana Polyclinic PC CurrentSince Mar 11, 2013 Accepting new patients
Major Hospital Past Accepting new patients
Meridian Health Group Pain Medicine PastSince Jan 22, 2004 Accepting new patients
Lebanon Health Associates, Inc. Past Accepting new patients

Locations

12772 Hamilton Crossing Blvd
Carmel, IN 46032
Phone (317) 805-5500

201 Pennsylvania Pkwy
Ste 200
Carmel, IN 46280
Phone (317) 805-5500

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

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": "1127347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1437523200000",
    "number": "1700872033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 PENNSYLVANIA PKWY",
            "address_2": "SUITE 200",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462802301",
            "telephone_number": "317-805-5500",
            "fax_number": "317-805-5501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 PENNSYLVANIA PKWY",
            "address_2": "SUITE 200",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462802301",
            "telephone_number": "317-805-5500",
            "fax_number": "317-805-5501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARBUCK",
        "first_name": "DMITRY",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-22",
        "last_updated": "2015-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "IN",
            "license": "01044705",
            "primary": true
        },
        {
            "code": "2084P2900X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Pain Medicine",
            "state": "IN",
            "license": "01044705A",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200163070",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.