Indiana Pediatric Associates LLC

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

INDIANA PEDIATRIC ASSOCIATES LLC

Practice address

655 N Broadway
Peru, IN 46970

Phone

(765) 475-0024

Fax

(765) 475-0736

NPI assigned

Nov 7, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Sherif Elmasry, MDNPI 1972690634

Title

Owner

Phone

(765) 475-0024

Specialties & licenses 1

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Sherif Elmasry

  • Pediatrics Physician
  • Peru, IN
  • NPI 1972690634
  NPD (past) Authorized official

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

{
    "created_epoch": "1162857600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1902975642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "655 N BROADWAY",
            "city": "PERU",
            "state": "IN",
            "postal_code": "46970",
            "telephone_number": "765-475-0024",
            "fax_number": "765-475-0736"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "655 N BROADWAY",
            "city": "PERU",
            "state": "IN",
            "postal_code": "46970",
            "telephone_number": "765-475-0024",
            "fax_number": "765-475-0736"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDIANA PEDIATRIC ASSOCIATES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-07",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ELMASRY",
        "authorized_official_first_name": "SHERIF",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "765-475-0024",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John Huber, BS
• Alicia Hughes, LMHC, LCAC
• Jack J Hughes III, COTA
• Debra Iles, BA
• Indiana Health Centers, Inc (Community Health Center of Miami County)
• Phyllis Annette Ingham, NP-C
• Innovative Hospital Care Inc
• Lacy Georgette Ireland, FNP
• Ivyrehab Physical Therapy, Occupational Therapy & Speech Language Path
• Stacey Jaberg

• Pediatrics Physician in Peru, IN
• Providers in Peru, IN by specialty
• Pediatrics Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.