Individual provider Active NPI

Stuart Andrew Creasey, PA-C

  • Physician Assistant
  • Carmel, IN
National Provider Identifier
1013496108
Registry record updated Aug 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
10002516A Issued in IN
Practice address
10767 Illinois St Ste 3000
Carmel, IN 46032-8972
Phone
(317) 817-1200
Fax
(317) 817-1220
NPI assigned
Aug 9, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 10002516A IN Primary

Addresses

Primary practice location

10767 Illinois St Ste 3000
Carmel, IN 46032-8972

Mailing address

10767 Illinois St Ste 3000
Carmel, IN 46032-8972
Phone (317) 817-1200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180830000242 IN Practitioner - Physician Assistant 4688924392 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Thomas a Brady Sports Medicine Center, PCGroup PAC ID 5991609281, 100 clinicians
US Therapy IncGroup PAC ID 6507893187, 81 clinicians

Practice addresses (Care Compare)

10767 Illinois St
Carmel, IN 46032-8972
Phone (317) 817-1200

1401 W County Line Rd
Methodist Sports Medicine
Greenwood, IN 46142-5195
Phone (317) 817-1200

3607 N Everbrook LN
Muncie, IN 47304-5220

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
10002516AINMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Thomas a Brady Sports Medicine Center, PC Physician Assistant CurrentSince Aug 7, 2018 Accepting new patients
Thomas a Brady Sports Medicine Center, PC CurrentSince Aug 7, 2018 Accepting new patients
Major Hospital Past Accepting new patients

Locations

10767 Illinois St
Ste 3000
Carmel, IN 46032
Phone (317) 708-6858

201 Pennsylvania Pkwy
Ste 100
Carmel, IN 46280
Phone (317) 817-1636

1401 W County Line Rd
Greenwood, IN 46142
Phone (317) 217-1200

Interoperability endpoints

  • Direct secure messaging: screasey424802@direct.franciscanalliance.org

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1533772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660176000000",
    "number": "1013496108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10767 ILLINOIS ST STE 3000",
            "city": "CARMEL",
            "state": "IN",
            "postal_code": "460328972",
            "telephone_number": "317-817-1200",
            "fax_number": "317-817-1220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10767 ILLINOIS ST STE 3000",
            "city": "CARMEL",
            "state": "IN",
            "postal_code": "460328972",
            "telephone_number": "317-817-1200",
            "fax_number": "317-817-1220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CREASEY",
        "first_name": "STUART",
        "middle_name": "ANDREW",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-08-09",
        "last_updated": "2022-08-11",
        "certification_date": "2022-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IN",
            "license": "10002516A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carmel, IN

Sources for this page

Verify at the official NPI Registry.