Individual provider Active NPI

Thomas Dascoli, M.D.

  • Family Medicine Physician
  • Indianapolis, IN
National Provider Identifier
1922049360
Registry record updated Jan 29, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
01024866 Issued in IN
Practice address
6920 Parkdale Place
Suite 106
Indianapolis, IN 46254-5604
Phone
(317) 329-7400
Fax
(317) 329-7447
NPI assigned
Jun 9, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 01024866 IN Primary

Addresses

Primary practice location

6920 Parkdale Place
Suite 106
Indianapolis, IN 46254-5604

Mailing address

250 N Shadeland Ave
Ste 130 Provider Enrollment
Indianapolis, IN 46219-4959

Other identifiers 1

IdentifierTypeStateIssuer
100356280MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01024866INMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Methodist Medical Group Physicians Inc Family Medicine Past Accepting new patients
The Salvation Army, an Illinois Corporation Past Accepting new patients
Major Hospital Past Accepting new patients
University Medical Diagnostic Associates, Inc. Past Accepting new patients
Healthnet, Inc. Past Accepting new patients

Organizations & group practices 5

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": "1149811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1390953600000",
    "number": "1922049360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 N SHADELAND AVE",
            "address_2": "STE 130 PROVIDER ENROLLMENT",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462194959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6920 PARKDALE PLACE",
            "address_2": "SUITE 106",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462545604",
            "telephone_number": "317-329-7400",
            "fax_number": "317-329-7447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DASCOLI",
        "first_name": "THOMAS",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-09",
        "last_updated": "2014-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01024866",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100356280",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.