Individual provider Active NPI

Justin Adam Magid, MD

  • Family Medicine Physician
  • Indianapolis, IN
National Provider Identifier
1861621625
Registry record updated Jun 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
01070391A Issued in IN
Practice address
10122 E 10TH St Ste 100
Indianapolis, IN 46229-2697
Phone
(317) 355-5717
Fax
(317) 355-3760
NPI assigned
Jul 14, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 11015133A IN
Family Medicine Physician 207Q00000X 01070391A IN Primary

Addresses

Primary practice location

10122 E 10TH St Ste 100
Indianapolis, IN 46229-2697

Mailing address

6626 E 75TH St
Suite 500
Indianapolis, IN 46250-2805

Other identifiers 2

IdentifierTypeStateIssuer
P01134432OtherINRR MEDICARE PTAN
201061870MedicaidIN

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
I20120607000606 IN Practitioner - Family Practice 1153585914 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Indiana University School of Medicine, 2009
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)

7250 Clearvista Dr
Suite 355
Indianapolis, IN 46256-5609
Phone (317) 621-5676

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01070391AINMDFamily Medicine Physician
11015133AINMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Community Physicians of Indiana Inc Family Medicine CurrentSince Jul 2, 2012 Accepting new patients
Community Physicians of Indiana Inc CurrentSince Jul 2, 2012 Accepting new patients

Locations

5819 Reliable Pkwy
Chicago, IL 60686

10122 E 10th St
Ste 100
Indianapolis, IN 46229
Phone (317) 355-5717

7250 Clearvista Dr
Ste 355
Indianapolis, IN 46256
Phone (317) 621-5673

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

1315 N Arlington Ave
Ste 100
Indianapolis, IN 46219
Phone (317) 322-2392

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

325 Westfield Rd
Ste A
Noblesville, IN 46060
Phone (317) 353-9336

Interoperability endpoints

  • Direct secure messaging: jmagid11807@ecommunitydirect.com

Organizations & group practices 2

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": "1247529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623196800000",
    "number": "1861621625",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6626 E 75TH ST",
            "address_2": "SUITE 500",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462502805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10122 E 10TH ST STE 100",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462292697",
            "telephone_number": "317-355-5717",
            "fax_number": "317-355-3760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAGID",
        "first_name": "JUSTIN",
        "middle_name": "ADAM",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-07-14",
        "last_updated": "2021-06-09",
        "certification_date": "2021-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "IN",
            "license": "11015133A",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01070391A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE PTAN",
            "identifier": "P01134432",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201061870",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.