Individual provider Active NPI

Jonathan D Moulder, MD

  • Family Medicine Physician
  • Indianapolis, IN
National Provider Identifier
1831459890
Registry record updated Jul 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
01075524A Issued in IN
Practice address
1040 Wishard Blvd
Indianapolis, IN 46202-2872
Phone
(317) 962-8893
Fax
(317) 962-6722
NPI assigned
May 24, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 01075524A IN Primary

Addresses

Primary practice location

1040 Wishard Blvd
Indianapolis, IN 46202-2872

Mailing address

1040 Wishard Blvd
Indianapolis, IN 46202-2872
Phone (317) 962-8893

Other practice location 1

5550 S East St Ste C
Indianapolis, IN 46227-1991
Phone (317) 534-4660

Other identifiers 1

IdentifierTypeStateIssuer
201093200MedicaidIN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jmoulder@direct.iuhealth.org

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
I20150706001828 IN Practitioner - Family Practice 4082850557 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Indiana University School of Medicine, 2012
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

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01075524AINMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Family Physicians, Inc. Family Medicine CurrentSince Aug 10, 2015 Accepting new patients
Windrose Health Network Inc Current Accepting new patients
Windrose Health Network, Inc. CurrentSince Sep 1, 2015 Accepting new patients
University Family Physicians, Inc. CurrentSince Aug 10, 2015 Accepting new patients
Iu Health Medical Group, LLC CurrentSince Jul 1, 2025 Accepting new patients
Windrose Health Network Inc CurrentSince Sep 1, 2015 Accepting new patients
Indiana University Health Care Associates, Inc CurrentSince Jul 22, 2017 Accepting new patients
Windrose Health Network, Inc. Past Accepting new patients
Windrose Health Network, Inc. Past Accepting new patients
Windrose Health Network, Inc. Past Accepting new patients
University Medical Diagnostic Associates, Inc. Past Accepting new patients
Major Hospital Past Accepting new patients
Windrose Health Network, Inc. Past Accepting new patients

Locations

5208 Reliable Pkwy
Chicago, IL 60686

7216 Solutions Ctr
Chicago, IL 60677

911 E Main Cross St
Edinburgh, IN 46124
Phone (317) 739-4895

55 N Milford Dr
Franklin, IN 46131
Phone (317) 648-7169

163 Butner Dr
Hope, IN 47246
Phone (812) 546-6000

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

8921 Southpointe Dr
Ste A1
Indianapolis, IN 46227
Phone (317) 780-7400

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

5550 S East St
Ste C
Indianapolis, IN 46227
Phone (317) 534-4660

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

1040 Wishard Blvd
Indianapolis, IN 46202
Phone (317) 278-1090

1520 N Senate Ave
Indianapolis, IN 46202
Phone (317) 962-0857

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

14 Trafalgar Sq
Trafalgar, IN 46181
Phone (317) 412-9190

Interoperability endpoints

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

Organizations & group practices 13

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.

View all 13

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": "1337817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785283200000",
    "number": "1831459890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1040 WISHARD BLVD",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462022872",
            "telephone_number": "317-962-8893",
            "fax_number": "317-962-6722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1040 WISHARD BLVD",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462022872",
            "telephone_number": "317-962-8893",
            "fax_number": "317-962-6722"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5550 S East St Ste C",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462271991",
            "country_code": "US",
            "telephone_number": "317-534-4660",
            "fax_number": "317-782-4301",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOULDER",
        "first_name": "JONATHAN",
        "middle_name": "D",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-05-24",
        "last_updated": "2026-07-29",
        "certification_date": "2026-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01075524A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201093200",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jmoulder@direct.iuhealth.org",
            "affiliation": "N",
            "address_1": "1520 N Senate Ave",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "462022213",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.