| Simran K Jutla, MD | |
|
705 Riley Hospital Dr, Indianapolis, IN 46202-5109 | |
| (317) 948-7208 | |
| (317) 944-7245 |
| Full Name | Simran K Jutla |
|---|---|
| Gender | Female |
| Speciality | Pediatrics - Pediatric Allergy/immunology |
| Location | 705 Riley Hospital Dr, Indianapolis, Indiana |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235633850 | NPI | - | NPPES |
| 1103673141 | Other | IN | ANTHEM PTAN |
| 300051677 | Medicaid | IN |
| Entity Name | Indiana Clinic Critical Care Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1417285230 PECOS PAC ID: 3678600988 Enrollment ID: O20100419000408 |
| Entity Name | Iu Health Medical Group Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1326893777 PECOS PAC ID: 9638617913 Enrollment ID: O20240817000533 |
| Mailing Address | Practice Location Address |
|---|---|
| Simran K Jutla, MD Po Box 778912, Chicago, IL 60677-8912 Ph: (317) 777-6435 | Simran K Jutla, MD 705 Riley Hospital Dr, Indianapolis, IN 46202-5109 Ph: (317) 948-7208 |
Mohannad Moallem, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 705 Riley Hospital Dr, Indianapolis, IN 46202 Phone: 317-274-4779 Fax: 317-948-9806 | |
Tracey Wilkinson, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 705 Riley Hospital Dr Ste 1300, Indianapolis, IN 46202 Phone: 317-962-8067 | |
Joshua Wayne Gollub, Pediatrics Medicare: Medicare Enrolled Practice Location: 705 Riley Hospital Dr, Indianapolis, IN 46202 Phone: 317-274-4779 Fax: 317-948-9806 | |
Katherine Carlsen Anderson, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 1701 N Senate Blvd # Ag012, Indianapolis, IN 46202 Phone: 317-962-3525 | |
Ivana Radovanovic, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 5550 S East St Ste C, Indianapolis, IN 46227 Phone: 317-534-4660 Fax: 317-782-4301 | |
Samuel J Flanders, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 250 N Shadeland Ave, Ste 200, Indianapolis, IN 46219 Phone: 317-962-4836 Fax: 317-962-8646 | |
Mark H Hoyer, MD Pediatrics Medicare: Accepting Medicare Assignments Practice Location: 705 Riley Hospital Dr, Rr 127, Indianapolis, IN 46202 Phone: 317-274-8906 Fax: 317-274-4022 |