Individual provider Active NPI

Michael D Glant, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • Indianapolis, IN
National Provider Identifier
1992815377
Registry record updated Jun 26, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
01026522 Issued in IN
Practice address
9550 Zionsville Rd
Suite #200
Indianapolis, IN 46268-1065
Phone
(317) 872-0116
Fax
(317) 874-1440
NPI assigned
Aug 30, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2009

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Cytopathology Physician 207ZC0500X NA IN
General Practice Physician 208D00000X 01026522 IN
General Practice Physician 208D00000X 036099561 IL
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 01026522 IN Primary

Addresses

Primary practice location

9550 Zionsville Rd
Suite #200
Indianapolis, IN 46268-1065

Mailing address

9550 Zionsville Rd
Suite #200
Indianapolis, IN 46268-1065
Phone (317) 872-0116

Other identifiers 12

IdentifierTypeStateIssuer
5811655OtherAETNA PPO
7100037900MedicaidKY
1992815377OtherMOBCBS-MO
5601593OtherAETNA HMO
100237180MedicaidIN
1100097OtherUHC MEDICARE COMPLETE
110884OtherININDIANA COMPREHENSIVE
1194840595OtherINANTHEM-IN
110884OtherINANTHEM BLUE SHIELD
2060835MedicaidOH
B29555OtherMERCY HEALTH PLAN HMO
238490OtherILHARMONY HEALTH

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
036099561ILMDGeneral Practice Physician
01026522INMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
DCL Laboratories LLC PastSince Oct 5, 2007 Accepting new patients
DCL Medical Laboratories LLC Past Accepting new patients

Organizations & group practices 2

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": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1245974400000",
    "number": "1992815377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9550 ZIONSVILLE RD",
            "address_2": "SUITE #200",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462681065",
            "telephone_number": "317-872-0116",
            "fax_number": "317-874-1440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9550 ZIONSVILLE RD",
            "address_2": "SUITE #200",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462681065",
            "telephone_number": "317-872-0116",
            "fax_number": "317-874-1440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLANT",
        "first_name": "MICHAEL",
        "middle_name": "D",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2009-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZC0500X",
            "taxonomy_group": "",
            "desc": "Pathology, Cytopathology",
            "state": "IN",
            "license": "NA",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "IN",
            "license": "01026522",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "IL",
            "license": "036099561",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "IN",
            "license": "01026522",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PPO",
            "identifier": "5811655",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100037900",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS-MO",
            "identifier": "1992815377",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HMO",
            "identifier": "5601593",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100237180",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UHC MEDICARE COMPLETE",
            "identifier": "1100097",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIANA COMPREHENSIVE",
            "identifier": "110884",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM-IN",
            "identifier": "1194840595",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BLUE SHIELD",
            "identifier": "110884",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2060835",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MERCY HEALTH PLAN HMO",
            "identifier": "B29555",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARMONY HEALTH",
            "identifier": "238490",
            "state": "IL"
        }
    ],
    "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 Jun 26, 2009; 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.