Active NPI
Su Mar Yar
- In Home Supportive Care Agency
- Fort Wayne, IN
National Provider Identifier
1083570485
On this page
Key facts
NPPES NPI Registry- Primary specialty
- In Home Supportive Care Agency
- License
- 24-0178031
- Practice address
- 410 W Concord LN
Fort Wayne, IN 46807-3525 - Phone
- (720) 936-0758
- NPI assigned
- Dec 29, 2025
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| In Home Supportive Care Agency | 253Z00000X | 24-0178031 | IN | Primary |
Addresses
Primary practice location
410 W Concord LN
Fort Wayne, IN 46807-3525
Mailing address
410 W Concord LN
Fort Wayne, IN 46807-3525
Phone (720) 936-0758
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 300099479 | Medicaid | IN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 24-0178031 | IN | MD | In Home Supportive Care Agency |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1766966400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1766966400000",
"number": "1083570485",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "410 W CONCORD LN",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "468073525",
"telephone_number": "720-936-0758"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "410 W CONCORD LN",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "468073525",
"telephone_number": "720-936-0758"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YAR",
"first_name": "SU",
"middle_name": "MAR",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2025-12-29",
"last_updated": "2025-12-29",
"certification_date": "2025-12-29",
"status": "A"
},
"taxonomies": [
{
"code": "253Z00000X",
"taxonomy_group": "",
"desc": "In Home Supportive Care",
"state": "IN",
"license": "24-0178031",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "300099479",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fort Wayne, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.