Individual provider Active NPI

Mary Margaret Spolyar, M.D.

  • Procedural Dermatology Physician
  • Indianapolis, IN
National Provider Identifier
1932169349
Registry record updated Apr 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Procedural Dermatology PhysicianTaxonomy code 207NS0135X
License
01047967A Issued in IN
Practice address
7910 N Shadeland Ave
Indianapolis, IN 46250-2041
Phone
(317) 516-5000
Fax
(317) 516-5146
NPI assigned
Mar 28, 2006
Last updated
Apr 5, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Procedural Dermatology Physician 207NS0135X 01047967A IN Primary

Addresses

Primary practice location

7910 N Shadeland Ave
Indianapolis, IN 46250-2041

Mailing address

7910 N Shadeland Ave
Indianapolis, IN 46250-2041
Phone (317) 516-5000

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address MSpolyar@directaddress.net

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
I20090728000619 IN Practitioner - Dermatology 7719089788 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Indiana University School of Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dawes Fretzin Dermatology Group, LLCGroup PAC ID 8820990872, 20 clinicians

Practice addresses (Care Compare)

7910 N Shadeland Ave
Indianapolis, IN 46250-2041
Phone (317) 516-5000

Merit-based Incentive Payment System (MIPS)

Final score
85.03 of 100Reported as group
Quality
68.51
Promoting interoperability
94
Improvement activities
40
Cost
86.6

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision27
Removal of skin lesions1391
Removal or shaving of skin growth157
Skin biopsy289

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01047967AINMDProcedural Dermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dawes Fretzin Dermatology Group, LLC CurrentSince Jul 1, 2009 Accepting new patients
Major Hospital Past Accepting new patients
West Kentucky Dermatology, PSC PastSince Jan 17, 2021 Accepting new patients
West Kentucky Dermatology, PSC Past Accepting new patients

Locations

7910 N Shadeland Ave
Indianapolis, IN 46250

8103 Clearvista Pkwy
Ste 220
Indianapolis, IN 46256
Phone (317) 588-7790

2220 W Alto Rd
Kokomo, IN 46902
Phone (317) 455-2577

Interoperability endpoints

  • Direct secure messaging: mspolyar@directaddress.net

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1143504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617580800000",
    "number": "1932169349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7910 N SHADELAND AVE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462502041",
            "telephone_number": "317-516-5000",
            "fax_number": "317-516-5146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7910 N SHADELAND AVE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462502041",
            "telephone_number": "317-516-5000",
            "fax_number": "317-516-5146"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPOLYAR",
        "first_name": "MARY",
        "middle_name": "MARGARET",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-28",
        "last_updated": "2021-04-05",
        "certification_date": "2021-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207NS0135X",
            "taxonomy_group": "",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "IN",
            "license": "01047967A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "MSpolyar@directaddress.net",
            "affiliation": "N",
            "address_1": "7910 N Shadeland Ave",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "462502041",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.