Active NPI
Michael T Crovello, MD
- Anesthesiology Physician
- Indianapolis, IN
National Provider Identifier
1861474868
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- 01045202
- Practice address
- 2001 W 86TH St
Indianapolis, IN 46260-1902 - Phone
- (866) 282-7905
- Fax
- (800) 731-0751
- NPI assigned
- Nov 16, 2005
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | 01045202 | IN | Primary |
Addresses
Primary practice location
2001 W 86TH St
Indianapolis, IN 46260-1902
Mailing address
PO Box 7232
Dept 165
Indianapolis, IN 46207-7232
Phone (317) 614-9817
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200085060 | Medicaid | IN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01045202 | IN | MD | Anesthesiology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1132099200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1548720000000",
"number": "1861474868",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 7232",
"address_2": "DEPT 165",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462077232",
"telephone_number": "317-614-9817",
"fax_number": "317-614-9655"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2001 W 86TH ST",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462601902",
"telephone_number": "866-282-7905",
"fax_number": "800-731-0751"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CROVELLO",
"first_name": "MICHAEL",
"middle_name": "T",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-11-16",
"last_updated": "2019-01-29",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "IN",
"license": "01045202",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200085060",
"state": "IN"
}
],
"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 Jan 29, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.