NPIMap

Individual provider Active NPI

Mandy M Caban, PA

  • Physician Assistant
  • Carmel, IN
National Provider Identifier
1811047574
Registry record updated Oct 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
10000881A Issued in IN
Practice address
5017 Surrey Lane
Carmel, IN 46033-9606
Phone
(574) 274-9147
NPI assigned
Jan 12, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 10000881A IN Primary

Addresses

Primary practice location

5017 Surrey Lane
Carmel, IN 46033-9606

Mailing address

5017 Surrey Lane
Carmel, IN 46033-9606

Other identifiers 2

IdentifierTypeStateIssuer
300007569MedicaidIN
P01291702OtherINRAILROAD MEDICARE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mcaban117375@eCommunityDirect.com Community Physicians of Indiana Inc

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Markle Medical Center, Inc Past Accepting new patients
Markle Medical Center, Inc Past Accepting new patients
Mesa Indiana Ed Associates, LLC Physician Assistant Past Accepting new patients
Saint Joseph Regional Medical Center, Inc. Past Accepting new patients
Markle Medical Center, Inc Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: mcaban117375@ecommunitydirect.com

Organizations & group practices 5

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1168560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730246400000",
    "number": "1811047574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5017 SURREY LANE",
            "city": "CARMEL",
            "state": "IN",
            "postal_code": "460339606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5017 SURREY LANE",
            "city": "CARMEL",
            "state": "IN",
            "postal_code": "460339606",
            "telephone_number": "574-274-9147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CABAN",
        "first_name": "MANDY",
        "middle_name": "M",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-12",
        "last_updated": "2024-10-30",
        "certification_date": "2024-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IN",
            "license": "10000881A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300007569",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P01291702",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mcaban117375@eCommunityDirect.com",
            "affiliation": "Y",
            "affiliationName": "Community Physicians of Indiana Inc",
            "address_1": "7120 Clearvista Dr",
            "address_2": "#4000",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "462561621",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Carmel, IN

Sources for this page

Verify at the official NPI Registry.