Individual provider Active NPI

Charles Miramonti, M.D.

  • Emergency Medicine Physician
  • Indianapolis, IN
National Provider Identifier
1922040922
Registry record updated Apr 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
01054513 Issued in IN
Practice address
5926 Crawfordsville Rd Unit B
Indianapolis, IN 46224-3722
Phone
(317) 653-2730
Fax
(317) 321-1935
NPI assigned
Jun 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 01054513 IN Primary
Emergency Medicine Physician 207P00000X 25IA12475000 NJ

Addresses

Primary practice location

5926 Crawfordsville Rd Unit B
Indianapolis, IN 46224-3722

Mailing address

PO Box 746720
Atlanta, GA 30374-6720
Phone (312) 733-7303

Other practice location 1

11260 E Jefferson Ave
Detroit, MI 48214-3320
Phone (313) 749-0148

Other practice location 2

1000 S Elmora Ave
Elizabeth, NJ 07202-3100
Phone (908) 737-5703

Other identifiers 1

IdentifierTypeStateIssuer
200384150MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN, PA, NJ3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20040604000110 IN Practitioner - Emergency Medicine 1557343381 Reassigns benefits to 1 organization
I20240926003617 PA Practitioner - Emergency Medicine 1557343381 Reassigns benefits to 1 organization
I20250403000127 NJ Practitioner - Emergency Medicine 1557343381 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01054513INMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Icem-Wishard LLC Emergency Medicine CurrentSince Aug 1, 2010 Accepting new patients
Osh-NJ Physicians Group PC CurrentSince Feb 19, 2025 Accepting new patients
Osh - PA Physicians Group, PC CurrentSince Sep 9, 2024 Accepting new patients
Indiana University Health Care Associates, Inc Past Accepting new patients
Emgi-Wishard Emergency Medicine Past Accepting new patients
Oak Street Health Physicians Group, PC PastSince May 28, 2019 Accepting new patients
Emergency Medical Group, Inc. Emergency Medicine Past Accepting new patients
University Emergency Medicine Emergency Medicine Past Accepting new patients
Osh-Mi Physicians Group PC Past Accepting new patients

Locations

5911 Reliable Pkwy
Chicago, IL 60686

30 W Monroe St
Ste 1200
Chicago, IL 60603
Phone (773) 609-1758

1001 W 10th St
Indianapolis, IN 46202
Phone (317) 630-6175

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

720 Eskenazi Ave
Indianapolis, IN 46202
Phone (317) 880-0000

1000 S Elmora Ave
Elizabeth, NJ 07202
Phone (908) 629-1265

3621 Aramingo Ave
Philadelphia, PA 19134
Phone (312) 600-8484

951 N 6th St
Ste 221
Reading, PA 19601
Phone (484) 207-2000

Interoperability endpoints

  • Direct secure messaging: charles.miramonti@oakstreethealth.gwaydirect.com

Organizations & group practices 9

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": "1150070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744848000000",
    "number": "1922040922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 746720",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303746720",
            "telephone_number": "312-733-7303",
            "fax_number": "773-866-8014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5926 CRAWFORDSVILLE RD UNIT B",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462243722",
            "telephone_number": "317-653-2730",
            "fax_number": "317-321-1935"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11260 E Jefferson Ave",
            "address_purpose": "LOCATION",
            "city": "Detroit",
            "state": "MI",
            "postal_code": "482143320",
            "country_code": "US",
            "telephone_number": "313-749-0148",
            "fax_number": "313-263-3298",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1000 S Elmora Ave",
            "address_purpose": "LOCATION",
            "city": "Elizabeth",
            "state": "NJ",
            "postal_code": "072023100",
            "country_code": "US",
            "telephone_number": "908-737-5703",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MIRAMONTI",
        "first_name": "CHARLES",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-12",
        "last_updated": "2025-04-17",
        "certification_date": "2025-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IN",
            "license": "01054513",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NJ",
            "license": "25IA12475000",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200384150",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.