NPIMap

Individual provider Active NPI

Sara G Fill, PA-C

  • Medical Physician Assistant
  • Grand Island, NE
National Provider Identifier
1104920461
Registry record updated Feb 28, 2008
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Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
1006 Issued in NE
Practice address
2116 W Faidley Ave
Grand Island, NE 68803-4645
Phone
(308) 398-5560
Fax
(308) 398-5306
NPI assigned
Sep 8, 2006
Last updated
Feb 28, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 1006 NE Primary

Addresses

Primary practice location

2116 W Faidley Ave
Grand Island, NE 68803-4645

Mailing address

8055 O St
Ste 300
Lincoln, NE 68510-2580
Phone (402) 421-0896

Other identifiers 3

IdentifierTypeStateIssuer
38734OtherNEBCBS NE CCH
244457OtherNEMIDLANDS CHOICE CCH
278972OtherNECOVENTRY CCH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071103000116 NE Practitioner - Physician Assistant 2365539590 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Grand Island Radiology Associates PCGroup PAC ID 7719978261, 44 clinicians

Practice addresses (Care Compare)

3610 Richmond Cir
Suite 100
Grand Island, NE 68803-3910
Phone (308) 398-6400

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Heartland Imaging Center of Hastings LLC PastSince May 24, 2020 Accepting new patients
Grand Island Regional Medical Center Past Accepting new patients
Lincoln Physician Network LLC Past Accepting new patients

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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": "1157673600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204156800000",
    "number": "1104920461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8055 O ST",
            "address_2": "STE 300",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685102580",
            "telephone_number": "402-421-0896",
            "fax_number": "402-421-0945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2116 W FAIDLEY AVE",
            "city": "GRAND ISLAND",
            "state": "NE",
            "postal_code": "688034645",
            "telephone_number": "308-398-5560",
            "fax_number": "308-398-5306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FILL",
        "first_name": "SARA",
        "middle_name": "G",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-08",
        "last_updated": "2008-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NE",
            "license": "1006",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS NE CCH",
            "identifier": "38734",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MIDLANDS CHOICE CCH",
            "identifier": "244457",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COVENTRY CCH",
            "identifier": "278972",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Island, NE

Sources for this page

Verify at the official NPI Registry.