Active NPI
Maxwell Bradley Bohrer
- Emergency Medicine Physician
- Indianapolis, IN
National Provider Identifier
1801633904
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- 11024175A
- Practice address
- 1701 N Senate Ave RM Ag012
Indianapolis, IN 46202-5306 - Phone
- (317) 962-5975
- NPI assigned
- Jul 15, 2024
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 11024175A | IN | Primary |
Addresses
Primary practice location
1701 N Senate Ave RM Ag012
Indianapolis, IN 46202-5306
Mailing address
485 N Elm St
Zionsville, IN 46077-1417
Phone (317) 753-4691
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
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250611003768 | IN | Order and Referring Only - Emergency Medicine | 2567972136 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11024175A | IN | MD | Emergency Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1721001600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1748908800000",
"number": "1801633904",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "485 N ELM ST",
"city": "ZIONSVILLE",
"state": "IN",
"postal_code": "460771417",
"telephone_number": "317-753-4691"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1701 N SENATE AVE RM AG012",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462025306",
"telephone_number": "317-962-5975"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOHRER",
"first_name": "MAXWELL",
"middle_name": "BRADLEY",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2024-07-15",
"last_updated": "2025-06-03",
"certification_date": "2025-06-03",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "IN",
"license": "11024175A",
"primary": true
}
],
"identifiers": [],
"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 Jun 3, 2025; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.