Individual provider Active NPI

Katherine Blaire Egan, MD

  • Plastic and Reconstructive Surgery Physician
  • Indianapolis, IN
National Provider Identifier
1790205706
Registry record updated Sep 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X
License
01091179A Issued in IN
Practice address
545 Barnhill Drive, Emerson Hall 232
Iu School of Medicine
Indianapolis, IN 46202
Phone
(317) 278-0394
NPI assigned
Jun 21, 2017
Last updated
Sep 26, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 11019435A IN
Plastic and Reconstructive Surgery Physician 2086S0122X 01091179A IN Primary

Addresses

Primary practice location

545 Barnhill Drive, Emerson Hall 232
Iu School of Medicine
Indianapolis, IN 46202

Mailing address

4506 N Pennsylvania St
Indianapolis, IN 46205-1730

Other identifiers 1

IdentifierTypeStateIssuer
300068731MedicaidIN

Other names 1

  • Katherine Blaire Kerwin Former name

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
I20231024002962 IN Practitioner - Plastic and Reconstructive Surgery 7618246646 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Plastic and Reconstructive Surgery
Education
Texas a & M University System, HSC, College of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Reconstructive Hand to Shoulder of Indiana LLCGroup PAC ID 7719088806, 8 clinicians
Community Physicians of Indiana IncGroup PAC ID 1759416662, 1,569 clinicians

Practice addresses (Care Compare)

13431 Old Meridian St
Suite 225
Carmel, IN 46032-1417
Phone (317) 249-2616

1400 N Ritter Ave
Suite 120
Indianapolis, IN 46219-3045
Phone (317) 355-1000

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of nail tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01091179AINMDPlastic and Reconstructive Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Reconstructive Hand to Shoulder of Indiana LLC CurrentSince Dec 1, 2025 Accepting new patients
Community Physicians of Indiana Inc CurrentSince Nov 27, 2023 Accepting new patients
Community Physicians of Indiana Inc CurrentSince Nov 27, 2023 Accepting new patients

Locations

5819 Reliable Pkwy
Chicago, IL 60686

13431 Old Meridian St
Ste 225
Carmel, IN 46032
Phone (317) 249-2616

1400 N Ritter Ave
Ste 120
Indianapolis, IN 46219
Phone (317) 355-1000

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1498003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758844800000",
    "number": "1790205706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4506 N PENNSYLVANIA ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462051730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "545 BARNHILL DRIVE, EMERSON HALL 232",
            "address_2": "IU SCHOOL OF MEDICINE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "46202",
            "telephone_number": "317-278-0394"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EGAN",
        "first_name": "KATHERINE",
        "middle_name": "BLAIRE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-21",
        "last_updated": "2025-09-26",
        "certification_date": "2025-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "IN",
            "license": "11019435A",
            "primary": false
        },
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "IN",
            "license": "01091179A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300068731",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHERINE",
            "last_name": "KERWIN",
            "middle_name": "BLAIRE",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.