Active NPI
Mark D Pescovitz X, M.D.
- Transplant Surgery Physician
- Indianapolis, IN
National Provider Identifier
1942211313
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Transplant Surgery Physician
- License
- 01036924A
- Practice address
- 550 University Blvd. #Uh 4601
Indianapolis, IN 46202 - Phone
- (317) 274-4370
- Fax
- (317) 278-3268
- NPI assigned
- Aug 11, 2006
- Last updated
- Aug 9, 2010
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Transplant Surgery Physician | 204F00000X | 01036924A | IN | Primary |
Addresses
Primary practice location
550 University Blvd. #Uh 4601
Indianapolis, IN 46202
Mailing address
550 University Blvd. #Uh 4601
Indianapolis, IN 46202
Phone (317) 274-4370
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200002680A | Medicaid | IN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155254400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1281312000000",
"number": "1942211313",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "550 UNIVERSITY BLVD. #UH 4601",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "46202",
"telephone_number": "317-274-4370",
"fax_number": "317-278-3268"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "550 UNIVERSITY BLVD. #UH 4601",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "46202",
"telephone_number": "317-274-4370",
"fax_number": "317-278-3268"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PESCOVITZ",
"first_name": "MARK",
"middle_name": "D",
"name_prefix": "Dr.",
"name_suffix": "X",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-11",
"last_updated": "2010-08-09",
"status": "A"
},
"taxonomies": [
{
"code": "204F00000X",
"taxonomy_group": "",
"desc": "Transplant Surgery",
"state": "IN",
"license": "01036924A",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200002680A",
"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 Aug 9, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.