MEDICARE: COMMUNITY IMAGING ASSOCIATES, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	293D00000X	Physiological Laboratory

General Provider Information

NPI Number	:	1235507773
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMMUNITY IMAGING ASSOCIATES, LLC

Provider Business Mailing Address
First Line	:	9998 CROSSPOINT BLVD STE 200
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46256-3307
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	11911 N MERIDIAN ST STE 128
Second Line	:
City	:	CARMEL
State	:	IN
Zip	:	46032-6904
Country	:	US
Telephone Number	:	317-621-6730
Fax Number	:	317-621-6778

Authorized Official
Title or Position	:	CHIEF FINANCIAL OFFICER
Name	:	DEBRA HAYES
Credential	:
Telephone Number	:	317-806-8254

Provider Enumeration Date	:	09/14/2015
Last Update Date	:	10/09/2025

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