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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 30 days.

IVAN ROUBAL MD
NPI 1033905013
Student in an Organized Health Care Education/Training Program in Indianapolis, IN

Active since April 16, 2025PECOS Enrolled
550 UNIVERSITY BLVD # 641, INDIANAPOLIS, IN 46202(317) 278-7056 Get Directions Write a Review

NPPES record last updated: July 4, 2026. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Ivan Roubal Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

IVAN ROUBAL MD (NPI 1033905013) is an individual student in an organized health care education/training program in Indianapolis, Indiana, licensed in Indiana (11025136A) and active in the NPI registry since April 2025. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1033905013
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameIVAN ROUBALCredential: MD
Location Address550 UNIVERSITY BLVD # 641Indianapolis, IN 46202-5149
Mailing Address550 University Blvd # 641Indianapolis, IN 46202-5149 · (317) 278-7056
Phone(317) 278-7056
Sole ProprietorNo
Enumeration DateApril 16, 2025
Last NPPES UpdateJuly 4, 2026
NPPES CertifiedJuly 4, 2026
✔ NPI 1033905013 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
License✔ Licensed in IN · 11025136A
Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

550 UNIVERSITY BLVD # 641, Indianapolis, IN 46202
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Ivan Roubal Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

FLORA AMY ACHIKO MD
Student in an Organized Health Care Education/Training Program
550 UNIVERSITY BLVD # 641
INDIANAPOLIS, IN 46202
Marion County (317) 948-2444
MAHMOOD KEDO MD
Student in an Organized Health Care Education/Training Program
550 UNIVERSITY BLVD # 641
INDIANAPOLIS, IN 46202
Marion County (317) 278-7056
KRISTIN CHERIE FRISBY DO
Radiology (Diagnostic Radiology)
550 UNIVERSITY BLVD # 641
INDIANAPOLIS, IN 46202
Marion County (317) 274-0010

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Ivan Roubal's NPI number?

The NPI number for Ivan Roubal is 1033905013. It was assigned to this individual provider in the NPPES registry on April 16, 2025.

Where is Ivan Roubal located?

Ivan Roubal practices at 550 University Blvd # 641, Indianapolis, IN 46202. The listed phone number is (317) 278-7056.

What is Ivan Roubal's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Ivan Roubal enrolled in Medicare?

Yes. Ivan Roubal is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Ivan Roubal was last updated on July 4, 2026. NPI Profile syncs with the weekly NPPES data releases published by CMS.