Individual provider Active NPI

Melissa Diane Anderson, MD

  • Nephrology Physician
  • Indianapolis, IN
National Provider Identifier
1871753152
Registry record updated May 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
01065758A Issued in IN
Practice address
5510 S East St Ste H
Indianapolis, IN 46227-1939
Phone
(317) 924-8425
NPI assigned
Jun 11, 2008
Last updated
May 31, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 31, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 01065758A IN Primary

Addresses

Primary practice location

5510 S East St Ste H
Indianapolis, IN 46227-1939

Mailing address

120 W 22ND St Ste 200
Oak Brook, IL 60523-1563

Other practice location 1

550 University Blvd Ste 2180
Indianapolis, IN 46202-5149
Phone (317) 944-8660

Other identifiers 2

IdentifierTypeStateIssuer
200911340MedicaidIN
P0084590OtherINRAIL ROAD MEDICARE

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address manderson2@direct.iuhealth.org
Direct Messaging Address credentialing@nephdocs.com Direct

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
I20081027000742 IN Practitioner - NephrologyPractitioner - Internal Medicine 9032277553 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
Southern Illinois University School of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Nephrology Associates of Northern Indiana PCGroup PAC ID 8921033440, 64 clinicians

Practice addresses (Care Compare)

5510 S E St
Suite H
Indianapolis, IN 46227-1939
Phone (317) 924-8425

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Nephrology Associates of Northern Indiana, Inc Nephrology CurrentSince Jan 1, 2022 Accepting new patients
University Medical Diagnostic Associates, Inc. Internal Medicine CurrentSince Jul 1, 2011 Accepting new patients
Major Hospital Past Accepting new patients

Locations

7301 Solutions Ctr
Chicago, IL 60677

120 W 22nd St
Ste 200
Oak Brook, IL 60523
Phone (630) 575-5000

569 Tyler St
Gary, IN 46402
Phone (260) 885-3300

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

1801 Senate Blvd
Ste 355
Indianapolis, IN 46202
Phone (317) 924-8420

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

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

250 N Shadeland Ave
Ste 200
Indianapolis, IN 46219
Phone (317) 962-4836

535 Barnhill Dr
#150
Indianapolis, IN 46202
Phone (317) 278-0221

550 University Blvd
Indianapolis, IN 46202
Phone (217) 274-5000

550 University Blvd
#2180
Indianapolis, IN 46202
Phone (317) 274-2891

5510 S East St
Ste H
Indianapolis, IN 46227
Phone (317) 924-8420

720 Eskenazi Ave
Fl 5
Indianapolis, IN 46202
Phone (317) 880-6000

90 W 86th Ave
Merrillville, IN 46410
Phone (219) 791-1555

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: manderson14538@direct.eskenazihealth.edu
  • Direct secure messaging: manderson2@direct.iuhealth.org
  • Direct secure messaging: manderson35700@direct.acumenmd.com
  • Direct secure messaging: manderson614966@direct.franciscanalliance.org

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 9

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": "1213142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653955200000",
    "number": "1871753152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 W 22ND ST STE 200",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605231563"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5510 S EAST ST STE H",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462271939",
            "telephone_number": "317-924-8425"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "550 University Blvd Ste 2180",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462025149",
            "country_code": "US",
            "telephone_number": "317-944-8660",
            "fax_number": "317-944-7459",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "MELISSA",
        "middle_name": "DIANE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-11",
        "last_updated": "2022-05-31",
        "certification_date": "2022-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "IN",
            "license": "01065758A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200911340",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD MEDICARE",
            "identifier": "P0084590",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "manderson2@direct.iuhealth.org",
            "affiliation": "N",
            "address_1": "550 University Blvd Ste 2180",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "462025149",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "credentialing@nephdocs.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "5510 S East St Ste H",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "462271939",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.