Individual provider Active NPI

Sara Rosemarie Saylor

  • Certified Registered Nurse Anesthetist
  • Mishawaka, IN
National Provider Identifier
1053938324
Registry record updated Jul 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
28240384A Issued in IN
Practice address
4455 Edison Lakes Pkwy # 100
Mishawaka, IN 46545-1414
Phone
(574) 231-6800
NPI assigned
Jul 2, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 2, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse AnesthetistGroup: 193400000X SINGLE SPECIALTY GROUP 367500000X 28240384A IN Primary

Addresses

Primary practice location

4455 Edison Lakes Pkwy # 100
Mishawaka, IN 46545-1414

Mailing address

60920 40TH St
Paw Paw, MI 49079-9753
Phone (269) 491-2633

Other identifiers 2

IdentifierTypeStateIssuer
28240384AOtherININDIANA STATE BOARD OF NURSING
4704278160OtherMIMICHIGAN STATE BOARD OF NURSING

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200826003674 IN Practitioner - Certified Registered Nurse Anesthetist (Crna) 1153748892 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Cardinal Anesthesia, LLC Single Specialty CurrentSince Aug 1, 2020 Accepting new patients
United Surgeons, LLC Single Specialty Current Accepting new patients
Sda Consultants PLLC Single Specialty CurrentSince Jul 1, 2021 Accepting new patients

Locations

500 Arcade Ave
Ste 100
Elkhart, IN 46514
Phone (574) 389-5683

51050 Bittersweet Rd
Granger, IN 46530
Phone (718) 208-0446

200 Missouri Ave
Bldg 18
Jeffersonvlle, IN 47130
Phone (502) 552-5221

4455 Edison Lakes Pkwy
#100
Mishawaka, IN 46545
Phone (574) 231-6800

4455 Edison Lakes Pkwy
Mishawaka, IN 46545
Phone (574) 231-6134

3930 Edison Lakes Pkwy
Ste 100
Mishawaka, IN 46545

1855 Powder Mill Rd
York, PA 17402

Organizations & group practices 3

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": "1593648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593648000000",
    "number": "1053938324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60920 40TH ST",
            "city": "PAW PAW",
            "state": "MI",
            "postal_code": "490799753",
            "telephone_number": "269-491-2633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4455 EDISON LAKES PKWY # 100",
            "city": "MISHAWAKA",
            "state": "IN",
            "postal_code": "465451414",
            "telephone_number": "574-231-6800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAYLOR",
        "first_name": "SARA",
        "middle_name": "ROSEMARIE",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-07-02",
        "last_updated": "2020-07-02",
        "certification_date": "2020-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IN",
            "license": "28240384A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIANA STATE BOARD OF NURSING",
            "identifier": "28240384A",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MICHIGAN STATE BOARD OF NURSING",
            "identifier": "4704278160",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mishawaka, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.