Individual provider Active NPI

Kelly Kathryn Hiatt, M.D.

  • Otolaryngology Physician
  • Indianapolis, IN
National Provider Identifier
1831357722
Registry record updated Jun 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
01065176A Issued in IN
Practice address
1400 N Ritter Ave Ste 230
Indianapolis, IN 46219-3046
Phone
(317) 355-2960
Fax
(317) 355-7784
NPI assigned
May 28, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 01065176A IN Primary

Addresses

Primary practice location

1400 N Ritter Ave Ste 230
Indianapolis, IN 46219-3046

Mailing address

6626 E 75TH St Ste 500
Indianapolis, IN 46250-2890
Phone (317) 355-2960

Other identifiers 2

IdentifierTypeStateIssuer
201064030MedicaidIN
P01723971OtherINRR MEDICARE

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address khiatt53573@eCommunityDirect.com Community Physicians of Indiana Inc
Direct Messaging Address KHIATT@OA2046.SRS-DIRECT.COM Direct Otolaryngology Associates, LLC

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
I20120703000661 IN Practitioner - Otolaryngology 3678738226 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Indiana University School of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Physicians of Indiana IncGroup PAC ID 1759416662, 1,569 clinicians

Practice addresses (Care Compare)

1400 N Ritter Ave
Suite 375B
Indianapolis, IN 46219-3052
Phone (317) 355-9370

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Otolaryngology Associates, LLC Otolaryngology CurrentSince Aug 1, 2016 Accepting new patients
Community Physicians of Indiana Inc CurrentSince Jul 25, 2016 Accepting new patients
Community Physicians of Indiana Inc CurrentSince Jul 25, 2016 Accepting new patients

Locations

5819 Reliable Pkwy
Chicago, IL 60686

1115 Ronald Reagan Pkwy
Ste 254
Avon, IN 46123
Phone (317) 705-2700

13100 E 136th St
Ste 1200
Fishers, IN 46037
Phone (317) 573-4370

7120 Clearvista Dr
Ste 4000
Indianapolis, IN 46256
Phone (317) 621-7444

1400 N Ritter Ave
Ste 230
Indianapolis, IN 46219
Phone (317) 355-2960

1400 N Ritter Ave
Ste 375B
Indianapolis, IN 46219
Phone (317) 355-9370

6626 E 75th St
Ste 500
Indianapolis, IN 46250
Phone (317) 621-7547

9002 N Meridian St
Ste 222
Indianapolis, IN 46260
Phone (317) 573-4370

5255 E Stop 11 Rd
Ste 400
Indianapolis, IN 46237
Phone (317) 528-6640

Interoperability endpoints

  • Direct secure messaging: khiatt@oa2046.srs-direct.com
  • Direct secure messaging: khiatt53573@ecommunitydirect.com
  • Direct secure messaging: khiatt53573@reidhealth.direct-ci.com
  • FHIR API: https://fhir4.healow.com/fhir/r4/IEEADA

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 2

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": "1211932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623974400000",
    "number": "1831357722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6626 E 75TH ST STE 500",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462502890",
            "telephone_number": "317-355-2960",
            "fax_number": "317-355-7784"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 N RITTER AVE STE 230",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462193046",
            "telephone_number": "317-355-2960",
            "fax_number": "317-355-7784"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HIATT",
        "first_name": "KELLY",
        "middle_name": "KATHRYN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-28",
        "last_updated": "2021-06-18",
        "certification_date": "2021-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "IN",
            "license": "01065176A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201064030",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P01723971",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "khiatt53573@eCommunityDirect.com",
            "affiliation": "Y",
            "affiliationName": "Community Physicians of Indiana Inc",
            "address_1": "1400 N Ritter Ave Ste 230",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "462193046",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "KHIATT@OA2046.SRS-DIRECT.COM",
            "affiliation": "Y",
            "affiliationName": "Otolaryngology Associates, LLC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "9002 North Meridian Street",
            "address_2": "Suite 222",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "462605350",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.