Individual provider Active NPI

Bruce W Van Natta, MD

  • Specialist
  • Indianapolis, IN
National Provider Identifier
1881652444
Registry record updated Apr 22, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
01031291A Issued in IN
Practice address
170 W 106TH St
Indianapolis, IN 46290-1004
Phone
(317) 575-0330
Fax
(317) 846-5719
NPI assigned
May 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 01031291A IN Primary

Addresses

Primary practice location

170 W 106TH St
Indianapolis, IN 46290-1004

Mailing address

170 W 106TH St
Indianapolis, IN 46290-1004
Phone (317) 575-0330

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
I20101215000981 IN Practitioner - Plastic and Reconstructive Surgery 5597782839 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Plastic and Reconstructive Surgery
Education
Indiana University School of Medicine, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Perkins Van Natta Plastic Surgery, P.C.Group PAC ID 6305812959, 4 clinicians

Practice addresses (Care Compare)

170 W 106TH St
Carmel, IN 46290-1004
Phone (317) 575-0330

Procedures performed for Medicare patients

ProcedureNumber of procedures
Mastectomy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01031291AINMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Associated Plastic Surgeons of Indiana PC Specialist PastSince Jul 19, 1993 Accepting new patients
Major Hospital Past Accepting new patients

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1146614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1398124800000",
    "number": "1881652444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "170 W 106TH ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462901004",
            "telephone_number": "317-575-0330",
            "fax_number": "317-846-5719"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "170 W 106TH ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462901004",
            "telephone_number": "317-575-0330",
            "fax_number": "317-846-5719"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN NATTA",
        "first_name": "BRUCE",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-03",
        "last_updated": "2014-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "IN",
            "license": "01031291A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.