Individual provider Active NPI

Sanjay Mohanty, MD

  • Colon & Rectal Surgery Physician
  • Indianapolis, IN
National Provider Identifier
1790071280
Registry record updated Aug 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Colon & Rectal Surgery PhysicianTaxonomy code 208C00000X
License
01082407A Issued in IN
Practice address
550 University Blvd Ste 1295
Indianapolis, IN 46202-5149
Phone
(317) 944-0931
NPI assigned
Jun 22, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 4301099184 MI
Surgery Physician 208600000X 01082407A IN
Colon & Rectal Surgery Physician 208C00000X 01082407A IN Primary

Addresses

Primary practice location

550 University Blvd Ste 1295
Indianapolis, IN 46202-5149

Mailing address

250 N Shadeland Ave
Indianapolis, IN 46219-4959

Other identifiers 2

IdentifierTypeStateIssuer
233690095OtherINMEDICARE PTAN
300027159MedicaidIN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address smohanty1@direct.iuhealth.org

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
I20190715000617 IN Practitioner - General Surgery 6305150756 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Indiana University School of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Iu Health Medical Group LLCGroup PAC ID 9638617913, 4,382 clinicians
University Surgeons IncGroup PAC ID 9436171949, 126 clinicians

Practice addresses (Care Compare)

1701 N Senate Blvd
Indianapolis, IN 46202-1239
Phone (888) 484-3258

550 University Blvd
Indianapolis, IN 46202-5149
Phone (317) 944-8330

Hospital & facility affiliations

  • Indiana University Health Hospital, Indianapolis, IN, CCN 150056

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Melanoma (skin cancer) excision1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301099184MIMDSurgery Physician
01082407AINMDColon & Rectal Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Surgeons, Inc. Surgery CurrentSince Sep 1, 2019 Accepting new patients
Iu Health Medical Group, LLC CurrentSince Jan 5, 2026 Accepting new patients
Major Hospital Past Accepting new patients

Locations

7630 Solutions Ctr
Chicago, IL 60677

1115 Ronald Reagan Pkwy
Avon, IN 46123
Phone (317) 217-2500

11725 Illinois St
Carmel, IN 46032
Phone (317) 617-4808

13000 E 136th St
Fishers, IN 46037
Phone (317) 678-2000

250 N Shadeland Ave
Indianapolis, IN 46219
Phone (317) 948-9174

550 University Blvd
Ste 1295
Indianapolis, IN 46202
Phone (317) 944-0931

250 N Shadeland Ave
Ste 200
Indianapolis, IN 46219
Phone (317) 962-4836

1701 Senate Blvd
Indianapolis, IN 46202
Phone (317) 612-2754

9660 E Washington St
Indianapolis, IN 46229
Phone (317) 329-7200

535 Barnhill Dr
Indianapolis, IN 46202
Phone (317) 274-2524

705 Riley Hospital Dr
Indianapolis, IN 46202
Phone (317) 274-4779

550 University Blvd
Indianapolis, IN 46202
Phone (217) 274-5000

1030 W Michigan St
Indianapolis, IN 46202
Phone (317) 944-0920

6850 Parkdale Pl
Indianapolis, IN 46254
Phone (317) 329-7209

1801 Senate Blvd
Ste 635
Indianapolis, IN 46202
Phone (317) 923-7211

720 Eskenazi Ave
Indianapolis, IN 46202
Phone (317) 880-0000

Interoperability endpoints

  • Direct secure messaging: smohanty70756@direct.eskenazihealth.edu
  • Direct secure messaging: smohanty1@direct.iuhealth.org

Organizations & group practices 3

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 1

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": "1308700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691971200000",
    "number": "1790071280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 N SHADELAND AVE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462194959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 UNIVERSITY BLVD STE 1295",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462025149",
            "telephone_number": "317-944-0931"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOHANTY",
        "first_name": "SANJAY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-22",
        "last_updated": "2023-08-14",
        "certification_date": "2023-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MI",
            "license": "4301099184",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IN",
            "license": "01082407A",
            "primary": false
        },
        {
            "code": "208C00000X",
            "taxonomy_group": "",
            "desc": "Colon & Rectal Surgery",
            "state": "IN",
            "license": "01082407A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "233690095",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300027159",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "smohanty1@direct.iuhealth.org",
            "affiliation": "N",
            "address_1": "550 University Blvd Ste 1295",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "462025149",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.