My Mobile Md Llc - Medicare Primary Care in Indianapolis, IN

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My Mobile Md Llc is a medicare enrolled primary clinic (Family Medicine) in Indianapolis, Indiana. The current practice location for My Mobile Md Llc is 429 E Vermont St Ste 110, Indianapolis, Indiana. For appointments, you can reach them via phone at (317) 559-0950. The mailing address for My Mobile Md Llc is 9165 Otis Ave, Suite 218, Indianapolis, Indiana and phone number is () -.

My Mobile Md Llc is licensed to practice in * (Not Available) (license number ). The clinic also participates in the medicare program and its NPI number is 1225495716. This medical practice accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at (317) 559-0950.

Contact Information

My Mobile Md Llc
429 E Vermont St Ste 110
Indianapolis
IN 46202-3685
(317) 559-0950
Not Available

Map and Direction


Primary Care Clinic Profile

Full NameMy Mobile Md Llc
SpecialityFamily Medicine
Location429 E Vermont St Ste 110, Indianapolis, Indiana
Authorized Official Name and PositionSteve Martin (CEO)
Authorized Official Contact3175590950
Accepts Medicare InsuranceYes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
My Mobile Md Llc
9165 Otis Ave
Suite 218
Indianapolis
IN 46216-2027

Ph: () -		My Mobile Md Llc
429 E Vermont St Ste 110
Indianapolis
IN 46202-3685

Ph: (317) 559-0950

NPI Details:

NPI Number1225495716
Provider Enumeration Date01/28/2016
Last Update Date04/21/2020

Medicare PECOS Information:

Medicare PECOS PAC ID1052617826
Medicare Enrollment IDO20160304001699

Medical Identifiers

Medical identifiers for My Mobile Md Llc such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1225495716NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207Q00000XFamily Medicine (* (Not Available))Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. My Mobile Md Llc acts as a billing entity for following providers:
Provider NameMarwan Mustaklem
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1750357513
PECOS PAC ID: 0941102644
Enrollment ID: I20070327000115
Provider NamePaula J Lowe
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1023291325
PECOS PAC ID: 7416039805
Enrollment ID: I20080501000349
Provider NameJoe Banks
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1154508075
PECOS PAC ID: 7113098765
Enrollment ID: I20080625000389
Provider NameDaniel A Anzaldua
Provider TypePractitioner - Nephrology
Provider IdentifiersNPI Number: 1811187818
PECOS PAC ID: 9436206729
Enrollment ID: I20090401000459
Provider NameTanya Ruth Reynolds
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1407954696
PECOS PAC ID: 6406905223
Enrollment ID: I20090527000078
Provider NameJeremy T Sullivan
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1053379644
PECOS PAC ID: 8729143615
Enrollment ID: I20090706000135
Provider NameChristina A Hoeg
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1205067022
PECOS PAC ID: 0345382636
Enrollment ID: I20100125000762
Provider NameStephanie S Wilson
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1336479161
PECOS PAC ID: 3476632431
Enrollment ID: I20100618000093
Provider NameTara A Mendoza
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1366742488
PECOS PAC ID: 0648455840
Enrollment ID: I20110504000182
Provider NamePatricia Mae Browning
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1760785091
PECOS PAC ID: 9234306796
Enrollment ID: I20120124000602
Provider NameAndrea Mcgaw
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1558704445
PECOS PAC ID: 4183867849
Enrollment ID: I20130827000920
Provider NameSom Dutt Tyagi
Provider TypePractitioner - Emergency Medicine
Provider IdentifiersNPI Number: 1366698177
PECOS PAC ID: 1254599657
Enrollment ID: I20131014000999
Provider NameMichelle Rene Lashorne
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1972945194
PECOS PAC ID: 5597995084
Enrollment ID: I20140301000047
Provider NameNatalie J Prater
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1912301938
PECOS PAC ID: 2860614203
Enrollment ID: I20141119001268
Provider NameAlicia Diane Hensley
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1346619715
PECOS PAC ID: 1557679412
Enrollment ID: I20150928000512
Provider NameSarah Parker
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1407207079
PECOS PAC ID: 1658665120
Enrollment ID: I20160805000776
Provider NameMeagan H. Corey
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1104278316
PECOS PAC ID: 5092009126
Enrollment ID: I20160811001431
Provider NameChatel A Beck
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1518406990
PECOS PAC ID: 3375828155
Enrollment ID: I20170317000128
Provider NameJason Soultz
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1669955449
PECOS PAC ID: 8921351289
Enrollment ID: I20181102001358
Provider NameMelissa Marie Etchison
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1518425727
PECOS PAC ID: 5991045734
Enrollment ID: I20190314001028
Provider NameRobert Justin Duprey
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1891290839
PECOS PAC ID: 5890059208
Enrollment ID: I20190321000220
Provider NameDanielle R Hollenbeck
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1659855310
PECOS PAC ID: 3577805746
Enrollment ID: I20190509000051
Provider NameMia Stowe
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1699243089
PECOS PAC ID: 3173866399
Enrollment ID: I20190509002490
Provider NameBobby Hill
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1457891806
PECOS PAC ID: 1759650963
Enrollment ID: I20190521003514
Provider NameRyan Matthew Pickell
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1578943460
PECOS PAC ID: 3870805294
Enrollment ID: I20190904001423
Provider NameVeena Reddy
Provider TypePractitioner - General Practice
Provider IdentifiersNPI Number: 1750671137
PECOS PAC ID: 9931400421
Enrollment ID: I20190917003862
Provider NameAngela Marie Eten
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1376041061
PECOS PAC ID: 7618225962
Enrollment ID: I20190926001592
Provider NameElizabeth Ann Adams
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1164847372
PECOS PAC ID: 8729393160
Enrollment ID: I20191115001363
Provider NameScott A Miller
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1255963575
PECOS PAC ID: 1850720244
Enrollment ID: I20200406003203
Provider NameHeather A Pickett
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1194490185
PECOS PAC ID: 8729483029
Enrollment ID: I20210825001525
Provider NameLauren Stewart
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1134893555
PECOS PAC ID: 3274939129
Enrollment ID: I20210915002835
Provider NameAshlee R Mack
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1942811682
PECOS PAC ID: 4183043755
Enrollment ID: I20211012002358
Provider NameDana L Fugate
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1235740085
PECOS PAC ID: 0648678235
Enrollment ID: I20211019003069
Provider NameShahlini K Mckinley
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1720308430
PECOS PAC ID: 3779676911
Enrollment ID: I20220125000170
Provider NameEmily Hackett
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1790440030
PECOS PAC ID: 1456746700
Enrollment ID: I20220323000994
Provider NameTamara Lynn Newsome
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1083205223
PECOS PAC ID: 9335535384
Enrollment ID: I20220331001252
Provider NameAdam James Tyler
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1174298764
PECOS PAC ID: 9739568288
Enrollment ID: I20220614001418
Provider NameDanielle Carpenter
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1609434539
PECOS PAC ID: 8527492636
Enrollment ID: I20220701001622
Provider NameMallory Anslow
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1386244176
PECOS PAC ID: 4880077957
Enrollment ID: I20220823001423
Provider NameJimmy L Chenowith
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1881353415
PECOS PAC ID: 6002292323
Enrollment ID: I20221010001998
Provider NameElizabeth Mary Kent
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1174240592
PECOS PAC ID: 8022485911
Enrollment ID: I20221107000450
Provider NameHeather Renee Gibbens
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1013628809
PECOS PAC ID: 3173989779
Enrollment ID: I20230524003251
Provider NameJustin Sweney
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1790479194
PECOS PAC ID: 2668832080
Enrollment ID: I20230718000260
Provider NameAmy Nicole Sparks
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1578344750
PECOS PAC ID: 5193174308
Enrollment ID: I20231213003323
Provider NameColin Deane Davenport
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1598545360
PECOS PAC ID: 2567983323
Enrollment ID: I20250310000864
Provider NameNicole M Wilson
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1205659323
PECOS PAC ID: 5395268718
Enrollment ID: I20250326002806

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Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.