Individual provider Active NPI

Sara Lynn Gonzalez, APN

  • Family Nurse Practitioner
  • Michigan City, IN
National Provider Identifier
1083996763
Registry record updated Jul 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
71003712A Issued in IN
Practice address
1225 E Coolspring Ave Ste 200
Michigan City, IN 46360-6312
Phone
(219) 861-8161
Fax
(219) 873-9504
NPI assigned
Sep 19, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 71003712A IN Primary

Addresses

Primary practice location

1225 E Coolspring Ave Ste 200
Michigan City, IN 46360-6312

Mailing address

PO Box 781076
Detroit, MI 48278-1076
Phone (317) 528-4800

Other practice location 1

2590 Morthland Dr
Valparaiso, IN 46385-6701
Phone (219) 861-8161

Other practice location 2

770 Indian Boundary Rd Ste 202
Chesterton, IN 46304-1519
Phone (219) 921-2000

Other identifiers 2

IdentifierTypeStateIssuer
000000926552OtherINANTHEM BCBS
201053810MedicaidIN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address sgonzalez46258@Direct.FranciscanAlliance.org Direct

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
I20120309000023 IN Practitioner - Nurse Practitioner 9931368040 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Franciscan Physician NetworkGroup PAC ID 3072790682, 1,152 clinicians

Practice addresses (Care Compare)

301 W Homer St
Michigan City, IN 46360-4358
Phone (219) 214-4400

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Franciscan Physician Network CurrentSince May 1, 2015 Accepting new patients
Franciscan Physician Network CurrentSince May 1, 2015 Accepting new patients

Locations

770 Indian Boundary Rd
Ste 202
Chesterton, IN 46304
Phone (219) 921-2000

1704 Lafayette Rd
Ste 4
Crawfordsvlle, IN 47933
Phone (765) 364-3120

1225 E Coolspring Ave
Ste 200
Michigan City, IN 46360
Phone (219) 861-8161

8865 W 400 N
Ste 105
Michigan City, IN 46360
Phone (219) 861-8740

301 W Homer St
Michigan City, IN 46360
Phone (219) 877-1033

1225 E Coolspring Ave
#200
Michigan City, IN 46360
Phone (219) 324-8860

150 W Washington St
Shelbyville, IN 46176
Phone (317) 392-3211

2590 Morthland Dr
Valparaiso, IN 46385
Phone (219) 531-0200

Interoperability endpoints

  • Direct secure messaging: sgonzalez46258@direct.franciscanalliance.org

Organizations & group practices 2

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.

Hospital & facility affiliations 2

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": "1316390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690761600000",
    "number": "1083996763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 781076",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482781076",
            "telephone_number": "317-528-4800",
            "fax_number": "317-865-1479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1225 E COOLSPRING AVE STE 200",
            "city": "MICHIGAN CITY",
            "state": "IN",
            "postal_code": "463606312",
            "telephone_number": "219-861-8161",
            "fax_number": "219-873-9504"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2590 Morthland Dr",
            "address_purpose": "LOCATION",
            "city": "Valparaiso",
            "state": "IN",
            "postal_code": "463856701",
            "country_code": "US",
            "telephone_number": "219-861-8161",
            "fax_number": "219-873-9504",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "770 Indian Boundary Rd Ste 202",
            "address_purpose": "LOCATION",
            "city": "Chesterton",
            "state": "IN",
            "postal_code": "463041519",
            "country_code": "US",
            "telephone_number": "219-921-2000",
            "fax_number": "219-395-8732",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "SARA",
        "middle_name": "LYNN",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-19",
        "last_updated": "2023-07-31",
        "certification_date": "2023-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71003712A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "000000926552",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201053810",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sgonzalez46258@Direct.FranciscanAlliance.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "8865 W 400 N Ste 105",
            "city": "Michigan City",
            "state": "IN",
            "country_code": "US",
            "postal_code": "463609223",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Michigan City, IN

Sources for this page

Verify at the official NPI Registry.