Individual provider Active NPI

Candice Diane Moad, NP

  • Gerontology Nurse Practitioner
  • Indianapolis, IN
National Provider Identifier
1942641840
Registry record updated Feb 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
71004660A Issued in IN
Practice address
355 W 16TH St
Suite 5100
Indianapolis, IN 46202-2207
Phone
(317) 396-1300
Fax
(317) 924-8472
NPI assigned
Jul 9, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 28170182A IN
Nurse Practitioner 363L00000X 71004660A IN
Gerontology Nurse Practitioner 363LG0600X 71004660A IN Primary

Addresses

Primary practice location

355 W 16TH St
Suite 5100
Indianapolis, IN 46202-2207

Mailing address

250 N Shadeland Ave
Indianapolis, IN 46219-4959

Other practice location 1

1701 N Senate Blvd
Indianapolis, IN 46202-1239
Phone (888) 484-3258

Other identifiers 3

IdentifierTypeStateIssuer
000001028014OtherINANTHEM PTAN
201212670MedicaidIN
000001297548OtherINANTHEM PTAN

Other names 1

  • Candice Diane Ellis Former name

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address cmoad@direct.iuhealth.org
Direct Messaging Address cmoad@direct.iuhealth.org Direct

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140326000846 IN Practitioner - Nurse Practitioner 8527299098 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Iu Health Medical Group LLCGroup PAC ID 9638617913, 4,382 clinicians

Practice addresses (Care Compare)

1701 N Senate Blvd
Indianapolis, IN 46202-1239
Phone (888) 484-3258

Hospital & facility affiliations

  • Indiana University Health Hospital, Indianapolis, IN, CCN 150056

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
28170182AINMDRegistered Nurse
71004660AINMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Iu Health Medical Group, LLC Nurse Practitioner CurrentSince Apr 1, 2025 Accepting new patients
University Family Physicians, Inc. CurrentSince Sep 1, 2019 Accepting new patients
University Family Physicians, Inc. CurrentSince Sep 1, 2019 Accepting new patients
Indiana Clinic Critical Care LLC CurrentSince Sep 12, 2016 Accepting new patients
Major Hospital Past Accepting new patients

Locations

2574 Reliable Pkwy
Chicago, IL 60686

7216 Solutions Ctr
Chicago, IL 60677

1111 Ronald Reagan Pkwy
Avon, IN 46123
Phone (317) 217-3000

1115 Ronald Reagan Pkwy
Ste 283
Avon, IN 46123

11725 Illinois St
Ste 465
Carmel, IN 46032
Phone (317) 688-5840

1411 W County Line Rd
Ste C
Greenwood, IN 46142
Phone (317) 888-1065

250 N Shadeland Ave
Indianapolis, IN 46219
Phone (317) 948-9174

355 W 16th St
Ste 5100
Indianapolis, IN 46202
Phone (317) 963-8145

1801 Senate Blvd
Ste 230
Indianapolis, IN 46202
Phone (317) 962-5280

1801 Senate Blvd
Ste 2000
Indianapolis, IN 46202
Phone (317) 962-0500

1633 N Capitol Ave
Ste 301
Indianapolis, IN 46202
Phone (317) 963-0601

1701 Senate Blvd
Indianapolis, IN 46202
Phone (317) 612-2754

4141 Shore Dr
Indianapolis, IN 46254
Phone (317) 329-2000

1520 N Senate Ave
Indianapolis, IN 46202
Phone (317) 962-0857

1000 S Main St
Tipton, IN 46072
Phone (765) 675-8500

Interoperability endpoints

  • Direct secure messaging: cmoad@direct.iuhealth.org
  • Direct secure messaging: candice.moadnp.p1@direct.goodmancampbell.nextgenshare.com

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1373328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739404800000",
    "number": "1942641840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 N SHADELAND AVE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462194959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "355 W 16TH ST",
            "address_2": "SUITE 5100",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462022207",
            "telephone_number": "317-396-1300",
            "fax_number": "317-924-8472"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1701 N Senate Blvd",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462021239",
            "country_code": "US",
            "telephone_number": "888-484-3258",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOAD",
        "first_name": "CANDICE",
        "middle_name": "DIANE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-09",
        "last_updated": "2025-02-13",
        "certification_date": "2025-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IN",
            "license": "28170182A",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IN",
            "license": "71004660A",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "IN",
            "license": "71004660A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM PTAN",
            "identifier": "000001028014",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201212670",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM PTAN",
            "identifier": "000001297548",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cmoad@direct.iuhealth.org",
            "affiliation": "N",
            "address_1": "355 W 16th St",
            "address_2": "Suite 5100",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "462022207",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cmoad@direct.iuhealth.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1701 N Senate Blvd",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "462021239",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "CANDICE",
            "last_name": "ELLIS",
            "middle_name": "DIANE",
            "credential": "ACNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.