Active NPI
Gerald A Kirk, MD
- Anesthesiology Physician
- Indianapolis, IN
National Provider Identifier
1730161241
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- 01040761
- Practice address
- 2001 W 86TH St
Indianapolis, IN 46260-1902 - Phone
- (317) 567-2180
- Fax
- (317) 567-2191
- NPI assigned
- Nov 18, 2005
- 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 |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | 01040761 | IN | Primary |
| Anesthesiology Physician | 207L00000X | 26042 | IA |
Addresses
Primary practice location
2001 W 86TH St
Indianapolis, IN 46260-1902
Mailing address
PO Box 7232
Dept 165
Indianapolis, IN 46207-7232
Phone (317) 567-2180
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100121770 | Medicaid | IN | |
| 70403 | Other | IA | WELLMARK BCBS |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Anesthesiology
- Education
- University of California, Geffen School of Medicine, 1980
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2001 W 86TH St
Indianapolis, IN 46260-1902
Phone (317) 338-2345
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01040761 | IN | MD | Anesthesiology Physician |
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 and National Provider Directory roles.
-
- Anesthesiology Physician
- Indianapolis, IN
- NPI 1568444693
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1132272000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1259798400000",
"number": "1730161241",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 7232",
"address_2": "DEPT 165",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462077232",
"telephone_number": "317-567-2180",
"fax_number": "317-567-2191"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2001 W 86TH ST",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462601902",
"telephone_number": "317-567-2180",
"fax_number": "317-567-2191"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIRK",
"first_name": "GERALD",
"middle_name": "A",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-11-18",
"last_updated": "2009-12-03",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "IN",
"license": "01040761",
"primary": true
},
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "IA",
"license": "26042",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100121770",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WELLMARK BCBS",
"identifier": "70403",
"state": "IA"
}
],
"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 3, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.