Individual provider Active NPI

Amy L Rau, PA-C

  • Medical Physician Assistant
  • Indianapolis, IN
National Provider Identifier
1063435865
Registry record updated May 25, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
10000888A Issued in IN
Practice address
2001 W 86TH St
Indianapolis, IN 46260
Phone
(317) 338-2121
NPI assigned
Jul 25, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 25, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Personal Emergency Response Attendant 146D00000X
Physician Assistant 363A00000X 50.002797 OH
Medical Physician Assistant 363AM0700X 10000888A IN Primary

Addresses

Primary practice location

2001 W 86TH St
Indianapolis, IN 46260

Mailing address

6625 Lowanna Way
Indianapolis, IN 46220-4364
Phone (513) 846-0521

Other identifiers 2

IdentifierTypeStateIssuer
000000947608OtherINANTHEM PIN
037870016OtherINMEDICARE ST. VINCENT

Other names 1

  • Amy L Snyder Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
50.002797OHMDPhysician Assistant
10000888AINMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
St. Vincent Emergency Physicians, Inc. CurrentSince Jun 1, 2015 Accepting new patients
Indiana Physician Management-Northeast, LLC CurrentSince Jun 1, 2015 Accepting new patients
University Medical Diagnostic Associates, Inc. Past Accepting new patients
Indiana Emergency Solutions LLC Past Accepting new patients

Locations

4685 Reliable Pkwy
Chicago, IL 60686

13861 Olio Rd
Fishers, IN 46037
Phone (317) 338-7136

2001 W 86th St
Indianapolis, IN 46260
Phone (317) 338-3617

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": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527206400000",
    "number": "1063435865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6625 LOWANNA WAY",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462204364",
            "telephone_number": "513-846-0521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 W 86TH ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "46260",
            "telephone_number": "317-338-2121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAU",
        "first_name": "AMY",
        "middle_name": "L",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-25",
        "last_updated": "2018-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "146D00000X",
            "taxonomy_group": "",
            "desc": "Personal Emergency Response Attendant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50.002797",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "IN",
            "license": "10000888A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM PIN",
            "identifier": "000000947608",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ST. VINCENT",
            "identifier": "037870016",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMY",
            "last_name": "SNYDER",
            "middle_name": "L",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.