Individual provider Active NPI

Adam D Bainbridge, D.O.

  • Family Medicine Physician
  • Indianapolis, IN
National Provider Identifier
1770712523
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
02003788A Issued in IN
Practice address
8177 Clearvista Pkwy
Indianapolis, IN 46256-1662
Phone
(317) 621-7801
Fax
(317) 621-7205
NPI assigned
Jul 14, 2009
Last updated
Nov 27, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 02003788A IN Primary

Addresses

Primary practice location

8177 Clearvista Pkwy
Indianapolis, IN 46256-1662

Mailing address

6626 E 75TH St
Suite 500
Indianapolis, IN 46250-2805

Other identifiers 2

IdentifierTypeStateIssuer
P01157035OtherINRR MEDICARE PTAN
201061630MedicaidIN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address abainbridge11803@eCommunityDirect.com Community Physicians of Indiana 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
I20120712000327 IN Practitioner - Family Practice 4587829874 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Lake Erie College of Osteopathic Medicine, Erie, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Physicians of Indiana IncGroup PAC ID 1759416662, 1,569 clinicians

Practice addresses (Care Compare)

1500 N Ritter Ave
Indianapolis, IN 46219-3027

1515 N Madison Ave
Anderson, IN 46011-3453

3500 S Lafountain St
Kokomo, IN 46902-3803
Phone (765) 453-8571

3504 S Lafountain St
Kokomo, IN 46902-3803
Phone (765) 453-8600

3506 S Lafountain St
Kokomo, IN 46902-3803
Phone (765) 865-6700

3508 S Lafountain St
Kokomo, IN 46902-3803
Phone (765) 776-5704

3510 S Lafountain St
Kokomo, IN 46902-3803
Phone (765) 864-8765

3512 S Lafountain St
Kokomo, IN 46902-3803
Phone (765) 865-6633

3548 S Lafountain St
Kokomo, IN 46902-3803
Phone (765) 773-8403

7120 Clearvista Dr
Suite 4000
Indianapolis, IN 46256-1774
Phone (317) 621-7444

8040 Clearvista Pkwy
Indianapolis, IN 46256-5604

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue607
Removal of skin lesions1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
02003788AINMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Community Physicians of Indiana Inc Family Medicine CurrentSince Aug 1, 2012 Accepting new patients
Community Physicians of Indiana Inc CurrentSince Aug 1, 2012 Accepting new patients
Major Hospital Past Accepting new patients

Locations

5819 Reliable Pkwy
Chicago, IL 60686

1500 N Ritter Ave
Indianapolis, IN 46219
Phone (317) 355-5041

6626 E 75th St
Ste 500
Indianapolis, IN 46250
Phone (317) 621-7547

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

8177 Clearvista Pkwy
Indianapolis, IN 46256
Phone (317) 621-7800

8177 Clearvista Pkwy
#100
Indianapolis, IN 46256
Phone (317) 621-7800

Interoperability endpoints

  • Direct secure messaging: abainbridge11803@ecommunitydirect.com

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 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": "1247529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1770712523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6626 E 75TH ST",
            "address_2": "SUITE 500",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462502805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8177 CLEARVISTA PKWY",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462561662",
            "telephone_number": "317-621-7801",
            "fax_number": "317-621-7205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAINBRIDGE",
        "first_name": "ADAM",
        "middle_name": "D",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-07-14",
        "last_updated": "2023-11-27",
        "certification_date": "2020-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "02003788A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE PTAN",
            "identifier": "P01157035",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201061630",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "abainbridge11803@eCommunityDirect.com",
            "affiliation": "Y",
            "affiliationName": "Community Physicians of Indiana Inc",
            "address_1": "8177 Clearvista Pkwy",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "462561662",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.