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1386364792

NPI Code Detail

MEDICARE: PEYTON WEST PA-C

MEDICARE: PEYTON WEST PA-C

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	363A00000X	Physician Assistant	10004048A	IN
2	390200000X	Student in an Organized Health Care Education/Training Program
3	363A00000X	Physician Assistant

General Provider Information

NPI Number	:	1386364792
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PEYTON WEST PA-C

Provider Business Mailing Address
First Line	:	401 E 34TH ST
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46205-3754
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	401 E 34TH ST
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46205-3754
Country	:	US
Telephone Number	:	317-396-0814
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/29/2022
Last Update Date	:	06/11/2026

Similar Medicare Providers

1528886579 — CHARITYE FORD LCSW
Practice Location Address:

401 E 34TH ST
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1407881303 — RACHEL L. ZIEGLER PSYD
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1265450779 — JENNIFER KATZ
Practice Location Address:

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Practice Phone: 317-226-4248
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1174544530 — DOROTHY C BOERSMA MD, MPH
Practice Location Address:

401 E 34TH ST
INDIANAPOLIS, IN
46205-3754

Practice Phone: 317-926-1507
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1619080694 — DR. RHONDA AMELIA STEPHENS DDS
Practice Location Address:

401 E 34TH ST , RAPHAEL HEALTH CENTER
INDIANAPOLIS, IN
46205-3754

Practice Phone: 317-860-3993
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1184751943 — ERIN A WALIA PA
Practice Location Address:

401 E 34TH ST
INDIANAPOLIS, IN
46205-3754

Practice Phone: 317-926-1507
Practice Fax: 317-926-1508

Directions to “ PEYTON WEST PA-C” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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