Individual provider Active NPI

Gregory J Mazanek, MD

  • Cardiovascular Disease Physician
  • Indianapolis, IN
National Provider Identifier
1710955166
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
01060905A Issued in IN
Practice address
10590 N Meridian St
Indianapolis, IN 46290-1028
Phone
(317) 338-6666
Fax
(317) 338-6066
NPI assigned
Mar 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 01060905A IN Primary
Internal Medicine Physician 207R00000X 01060905A IN

Addresses

Primary practice location

10590 N Meridian St
Indianapolis, IN 46290-1028

Mailing address

10590 N Meridian St
Carmel, IN 46290-1028

Other identifiers 2

IdentifierTypeStateIssuer
P00367799OtherINRRMC - CARDIOVASCULAR DIAGNOSTIC SERVICES
200526150MedicaidIN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address gregory.mazanek.1@7598.direct.athenahealth.com St. Vincent Medical Group, 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
I20050811001086 IN Practitioner - Cardiovascular Disease (Cardiology) 4385636075 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Jefferson Medical College of Thomas Jefferson University, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Vincent Medical Group IncGroup PAC ID 7012047640, 728 clinicians

Practice addresses (Care Compare)

10580 N Meridian St
Carmel, IN 46290-1028
Phone (317) 583-5000

10590 N Meridian St
Carmel, IN 46290-1028

1214 E National Ave
Suite 100
Brazil, IN 47834-2700
Phone (812) 442-2820

250 W 96TH St
Suite 520
Indianapolis, IN 46260-1317

8333 Naab Rd
Suite 420
Indianapolis, IN 46260-1992
Phone (317) 338-6666

8433 Harcourt Rd
Suite 100
Indianapolis, IN 46260-2193
Phone (317) 583-7600

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01060905AINMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Vincent Physician Services Hospital and Health Care Center CurrentSince Jun 11, 2014 Accepting new patients
St Vincent Physician Services Hospital and Health Care Center Internal Medicine CurrentSince Jun 11, 2014 Accepting new patients
St Vincent Medical Group Inc Cardiovascular Disease Past Accepting new patients
Major Hospital Past Accepting new patients

Locations

2001 W 86th St
Indianapolis, IN 46260
Phone (317) 338-3617

8240 Naab Rd
Ste 155
Indianapolis, IN 46260
Phone (317) 338-7760

250 W 96th St
Ste 520
Indianapolis, IN 46260
Phone (317) 583-3211

8333 Naab Rd
Ste 335
Indianapolis, IN 46260
Phone (317) 338-5066

8333 Naab Rd
Ste 400
Indianapolis, IN 46260
Phone (317) 338-5066

8240 Naab Rd
Ste 100
Indianapolis, IN 46260
Phone (317) 338-7450

8333 Naab Rd
Indianapolis, IN 46260
Phone (317) 338-3103

8333 Naab Rd
#180B
Indianapolis, IN 46260
Phone (317) 338-6666

Interoperability endpoints

  • Direct secure messaging: gregory.mazanek.1@7598.direct.athenahealth.com

Ownership & related parties

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Ascension St Vincent Heart CenterCarmel, IN, CCN 150153 Hospital Corporate Director Jul 1, 2021
Ascension Medical Group St. VincentNorth Vernon, IN, CCN 153887 Rural health clinic Corporate Director Jul 1, 2012

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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 6

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": "1141948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1710955166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10590 N MERIDIAN ST",
            "city": "CARMEL",
            "state": "IN",
            "postal_code": "462901028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10590 N MERIDIAN ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462901028",
            "telephone_number": "317-338-6666",
            "fax_number": "317-338-6066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAZANEK",
        "first_name": "GREGORY",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-10",
        "last_updated": "2022-07-21",
        "certification_date": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "IN",
            "license": "01060905A",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IN",
            "license": "01060905A",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RRMC - CARDIOVASCULAR DIAGNOSTIC SERVICES",
            "identifier": "P00367799",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200526150",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "gregory.mazanek.1@7598.direct.athenahealth.com",
            "affiliation": "Y",
            "affiliationName": "St. Vincent Medical Group, Inc.",
            "address_1": "10590 N Meridian St",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "462901028",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.