Ivan Lupov, M.D.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

11018664A Issued in IN

Practice address

1701 N Senate Blvd
Iusom Department of Emergency Medicine, Room Ag012
Indianapolis, IN 46202-1239

Phone

(317) 962-5975

NPI assigned

May 21, 2016

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Emergency Medicine

Education

Indiana University School of Medicine, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Iu Health Medical Group LLCGroup PAC ID 9638617913, 4,382 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Indiana University Health Bloomington Hospital Hospital, Bloomington, IN, CCN 150051
• Indiana University Health Paoli Hospital Hospital, Paoli, IN, CCN 151306

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Iu Health Medical Group, LLC

  • General Practice Physician
  • Indianapolis, IN
  • NPI 1326893777
  Medicare reassignment Care Compare group NPD
• Indiana University Health Southern Indiana Physicians, LLC

  • Multi-Specialty Clinic/Center
  • Bloomington, IN
  • NPI 1013953983
  Medicare reassignment
• Emergency Physicians Inc of Columbus

  • Emergency Medicine Physician
  • Columbus, IN
  • NPI 1912951062
  NPD

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

• Indiana University Health Bloomington Inc

  • General Acute Care Hospital
  • Bloomington, IN
  • NPI 1205860335
  Care Compare affiliation
• Indiana University Health Paoli Inc

  • Critical Access Hospital
  • Paoli, IN
  • NPI 1912984451
  Care Compare affiliation

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

{
    "created_epoch": "1463788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550188800000",
    "number": "1942657747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5034 N CAPITOL AVE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462083405",
            "telephone_number": "812-322-1487"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 N SENATE BLVD",
            "address_2": "IUSOM DEPARTMENT OF EMERGENCY MEDICINE, ROOM AG012",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462021239",
            "telephone_number": "317-962-5975"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "601 W 2nd St",
            "address_purpose": "LOCATION",
            "city": "Bloomington",
            "state": "IN",
            "postal_code": "474032317",
            "country_code": "US",
            "telephone_number": "812-353-9515",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LUPOV",
        "first_name": "IVAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-05-21",
        "last_updated": "2019-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IN",
            "license": "11018664A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Julie Luo
• Tianqi Luo, DO
• Marissa Justine Luoma, MD
• Leslie Luong
• Hillary Lupo, MSP-CFY
• Jonathan Baker Lupton, M.D.
• John J Lurkins, LCSW
• Erin Lushin, PHARMD
• Hattie Quinlin Lusk
• Debra K Lustig, NP

• Emergency Medicine Physician in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Emergency Medicine Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.