MEDICARE: PETER J HEALY DO

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	207P00000X	Emergency Medicine Physician	02002816	IN
2	207P00000X	Emergency Medicine Physician	02002816A	IN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1528006657
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PETER J HEALY DO

Provider Business Mailing Address
First Line	:	250 N SHADELAND AVE
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46219-4959
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	13100 136TH STREET
Second Line	:
City	:	FISHERS
State	:	IN
Zip	:	46037-9478
Country	:	US
Telephone Number	:	317-944-4705
Fax Number	:	317-678-1325

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

Provider Enumeration Date	:	06/02/2006
Last Update Date	:	05/23/2025

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Directions to “ PETER J HEALY DO” Practice Location

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