MEDICARE: INDIANA UNIVERSITY HEALTH AMBULATORY SURGERY CENTERS, 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	261QA1903X	Ambulatory Surgical Clinic/Center

General Provider Information

NPI Number	:	1902793375
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INDIANA UNIVERSITY HEALTH AMBULATORY SURGERY CENTERS, LLC

Provider Business Mailing Address
First Line	:	950 N MERIDIAN ST STE 1200
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46204-1011
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6850 PARKDALE PL
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46254-4670
Country	:	US
Telephone Number	:	317-890-5400
Fax Number	:

Authorized Official
Title or Position	:	AE
Name	:	MIKE BROWN
Credential	:
Telephone Number	:	317-963-8809

Provider Enumeration Date	:	06/19/2025
Last Update Date	:	03/02/2026

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