NPIMap

Individual provider Active NPI

Mini Sra

  • Internal Medicine Physician
  • Mishawaka, IN
National Provider Identifier
1003122003
Registry record updated Nov 3, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
01072359A Issued in IN
Practice address
5215 Holy Cross Pkwy
Mishawaka, IN 46545-1469
Phone
(574) 335-2521
Fax
(574) 335-2262
NPI assigned
Aug 27, 2010
Last updated
Nov 3, 2016By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 3, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 01072359A IN Primary

Addresses

Primary practice location

5215 Holy Cross Pkwy
Mishawaka, IN 46545-1469

Mailing address

5215 Holy Cross Pkwy
Mishawaka, IN 46545-1469
Phone (574) 335-2521

Other names 1

  • Mandeep Sra Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131113001394 IN Practitioner - HospitalistPractitioner - Internal Medicine 2264668698 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Internal Medicine
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Apogee Medical Group Indiana PCGroup PAC ID 8729155742, 70 clinicians

Practice addresses (Care Compare)

520 S 7TH St
Vincennes, IN 47591-1038
Phone (812) 882-5220

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.8 of 100Reported as group
Quality
83.98
Improvement activities
40
Cost
76.51

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
01072359AINMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Apogee Medical Group, Indiana, PC Internal Medicine CurrentSince Oct 1, 2017 Accepting new patients
Sound Physicians of Indiana, LLC Internal Medicine CurrentSince Jul 6, 2013 Accepting new patients
Sound Physicians of Indiana, LLC Internal Medicine CurrentSince Jul 6, 2013 Accepting new patients

Locations

601 W 2nd St
Bloomington, IN 47403
Phone (812) 353-5252

5215 Holy Cross Pkwy
Mishawaka, IN 46545
Phone (574) 335-2443

520 S 7th St
Vincennes, IN 47591
Phone (812) 885-3280

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1282867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478131200000",
    "number": "1003122003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5215 HOLY CROSS PKWY",
            "city": "MISHAWAKA",
            "state": "IN",
            "postal_code": "465451469",
            "telephone_number": "574-335-2521",
            "fax_number": "574-335-2262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5215 HOLY CROSS PKWY",
            "city": "MISHAWAKA",
            "state": "IN",
            "postal_code": "465451469",
            "telephone_number": "574-335-2521",
            "fax_number": "574-335-2262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SRA",
        "first_name": "MINI",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-08-27",
        "last_updated": "2016-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IN",
            "license": "01072359A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MANDEEP",
            "last_name": "SRA",
            "credential": "MBBS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Mishawaka, IN

Sources for this page

Verify at the official NPI Registry.