Individual provider Active NPI

Timothy J Ellender, MD

  • Emergency Medicine Physician
  • Indianapolis, IN
National Provider Identifier
1811902133
Registry record updated Mar 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
01059432A Issued in IN
Practice address
1701 N Senate Blvd
Indianapolis, IN 46202-1239
Phone
(888) 484-3258
NPI assigned
Jul 29, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 01059432 IN
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 01059432A IL
Emergency Medicine Physician 207P00000X 01059432A IN Primary

Addresses

Primary practice location

1701 N Senate Blvd
Indianapolis, IN 46202-1239

Mailing address

250 N Shadeland Ave
Indianapolis, IN 46219-4959
Phone (877) 668-5621

Other practice location 1

1701 Senate Blvd
Ag383
Indianapolis, IN 46202-1239
Phone (317) 962-4836

Other practice location 2

720 Eskenazi Ave
Indianapolis, IN 46202-5187
Phone (317) 639-6671

Other identifiers 2

IdentifierTypeStateIssuer
P00920827OtherINRAILROAD MEDICARE PIN
200841330MedicaidIN

Electronic endpoints 3

TypeEndpointUseAffiliation
Direct Messaging Address tellender@direct.iuhealth.org
Direct Messaging Address tellender@direct.iuhealth.org Direct
Direct Messaging Address tellende@iu.edu

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
I20061211000172 IN Practitioner - Emergency Medicine 7113926676 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Iu Health Medical Group LLCGroup PAC ID 9638617913, 4,382 clinicians

Practice addresses (Care Compare)

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

Hospital & facility affiliations

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

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01059432INMDEmergency Medicine Physician
01059432AINMDEmergency Medicine Physician
01059432AILMDCritical Care Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Icem-Wishard LLC Emergency Medicine CurrentSince Sep 1, 2022 Accepting new patients
Indiana Clinic Critical Care LLC Critical Care Medicine CurrentSince Feb 15, 2010 Accepting new patients
Iu Health Medical Group, LLC CurrentSince Apr 1, 2025 Accepting new patients
Indiana University Health Care Associates, Inc CurrentSince Apr 22, 2010 Accepting new patients
Emergency Medical Group, Inc. Emergency Medicine Past Accepting new patients
Respiratory & Critical Care Consultants P C Critical Care Medicine Past Accepting new patients
University Medical Diagnostic Associates, Inc. Past Accepting new patients

Locations

5911 Reliable Pkwy
Chicago, IL 60686

5208 Reliable Pkwy
Chicago, IL 60686

2574 Reliable Pkwy
Chicago, IL 60686

13500 N Meridian St
Carmel, IN 46032
Phone (317) 573-7000

250 N Shadeland Ave
Ste 130
Indianapolis, IN 46219
Phone (317) 962-4836

1801 Senate Blvd
Ste 230
Indianapolis, IN 46202
Phone (317) 962-5280

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

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

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

1701 Senate Blvd
#383
Indianapolis, IN 46202
Phone (317) 929-8880

1801 Senate Blvd
Indianapolis, IN 46202
Phone (317) 929-8880

1701 N Senate Blvd
Bldg C6
Indianapolis, IN 46202
Phone (913) 962-2000

Interoperability endpoints

  • Direct secure messaging: tellender@direct.iuhealth.org

Organizations & group practices 7

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": "1154131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741564800000",
    "number": "1811902133",
    "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",
            "telephone_number": "877-668-5621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 N SENATE BLVD",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462021239",
            "telephone_number": "888-484-3258"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1701 Senate Blvd",
            "address_2": "AG383",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462021239",
            "country_code": "US",
            "telephone_number": "317-962-4836",
            "fax_number": "317-962-4811",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "720 Eskenazi Ave",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462025187",
            "country_code": "US",
            "telephone_number": "317-639-6671",
            "fax_number": "317-963-5492",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ELLENDER",
        "first_name": "TIMOTHY",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-29",
        "last_updated": "2025-03-10",
        "certification_date": "2025-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IN",
            "license": "01059432",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "IL",
            "license": "01059432A",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IN",
            "license": "01059432A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE PIN",
            "identifier": "P00920827",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200841330",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tellender@direct.iuhealth.org",
            "affiliation": "N",
            "address_1": "1701 Senate Blvd",
            "address_2": "AG383",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "462021239",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tellender@direct.iuhealth.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "720 Eskenazi Ave",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "462025187",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tellende@iu.edu",
            "affiliation": "N",
            "address_1": "1701 N Senate Blvd",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "462021239",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.