Individual provider Active NPI

Emanuel David Rivas Chacon, MD

  • Internal Medicine Physician
  • Indianapolis, IN
National Provider Identifier
1780186858
Registry record updated Jul 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
01093880A Issued in IN
Practice address
2001 W 86TH St
Indianapolis, IN 46260-1902
Phone
(317) 338-2345
NPI assigned
Mar 6, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 01093880A IN Primary

Addresses

Primary practice location

2001 W 86TH St
Indianapolis, IN 46260-1902

Mailing address

2001 W 86TH St
Indianapolis, IN 46260-1902

Other practice location 1

3134 N Clark St
Chicago, IL 60657-4414
Phone (312) 766-4949

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
I20240715001539 IN Practitioner - Internal Medicine 8224573209 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2017
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

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
St. Vincent Medical Group, Inc. Internal Medicine CurrentSince Nov 1, 2024 Accepting new patients
St Vincent Physician Services Hospital and Health Care Center Internal Medicine CurrentSince Aug 4, 2024 Accepting new patients
St Vincent Physician Services Hospital and Health Care Center CurrentSince Aug 4, 2024 Accepting new patients
St. Vincent Medical Group, Inc. Internal Medicine CurrentSince Nov 1, 2024 Accepting new patients

Locations

2015 Jackson St
Anderson, IN 46016
Phone (765) 646-8243

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

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

8433 Harcourt Rd
Ste 100
Indianapolis, IN 46260
Phone (317) 583-7702

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

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

Interoperability endpoints

  • Direct secure messaging: emanuel.rivaschacon@509680731226116.direct.elationemr.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 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": "1520294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722211200000",
    "number": "1780186858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 W 86TH ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462601902"
        },
        {
            "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": "317-338-2345"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3134 N Clark St",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606574414",
            "country_code": "US",
            "telephone_number": "312-766-4949",
            "fax_number": "312-766-4925",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RIVAS CHACON",
        "first_name": "EMANUEL",
        "middle_name": "DAVID",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-06",
        "last_updated": "2024-07-29",
        "certification_date": "2024-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IN",
            "license": "01093880A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.