Individual provider Active NPI

Anne Marie Bianculli, M.D.

  • Pediatrics Physician
  • Lafayette, IN
National Provider Identifier
1891012712
Registry record updated Oct 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
01072341A Issued in IN
Practice address
2600 Greenbush St
Lafayette, IN 47904-2477
Phone
(765) 448-8000
NPI assigned
May 2, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2013

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
Pediatrics Physician 208000000X 01072341A IN Primary

Addresses

Primary practice location

2600 Greenbush St
Lafayette, IN 47904-2477

Mailing address

PO Box 5545
Lafayette, IN 47903-5545
Phone (765) 448-8000

Other identifiers 2

IdentifierTypeStateIssuer
000000820015OtherINANTHEM PROVIDER NUMBER
201099160MedicaidIN

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
I20130715000503 IN Practitioner - Pediatric Medicine 8729228739 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01072341AINMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Arnett Clinic, LLC Pediatrics CurrentSince Jul 1, 2013 Accepting new patients
Arnett Clinic, LLC Current Accepting new patients
Iu Health Medical Group, LLC CurrentSince Jan 1, 2026 Accepting new patients
Arnett Clinic, LLC CurrentSince Jul 1, 2013 Accepting new patients

Locations

8016 Reliable Pkwy
Chicago, IL 60686

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

2600 Greenbush St
Lafayette, IN 47904

253 Sagamore Pkwy W
West Lafayette, IN 47906

Interoperability endpoints

  • Direct secure messaging: abiancul@direct.iuhealth.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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1272758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1380844800000",
    "number": "1891012712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5545",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479035545",
            "telephone_number": "765-448-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 GREENBUSH ST",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479042477",
            "telephone_number": "765-448-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BIANCULLI",
        "first_name": "ANNE",
        "middle_name": "MARIE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-05-02",
        "last_updated": "2013-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IN",
            "license": "01072341A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM PROVIDER NUMBER",
            "identifier": "000000820015",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201099160",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lafayette, IN

Sources for this page

Verify at the official NPI Registry.