Individual provider Active NPI

Abigail G Boris, APRN

  • Adult Health Nurse Practitioner
  • Indianapolis, IN
National Provider Identifier
1114464575
Registry record updated Aug 2, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
71007760A Issued in IN
Practice address
3834 S Emerson Ave
BLDG C Ste 100
Indianapolis, IN 46203
Phone
(317) 782-1577
Fax
(888) 366-7577
NPI assigned
Jan 24, 2017
Last updated
Aug 2, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 71007760A IN Primary
Gerontology Nurse Practitioner 363LG0600X 71007760A IN
Registered Nurse 163W00000X 28191010A IN

Addresses

Primary practice location

3834 S Emerson Ave
BLDG C Ste 100
Indianapolis, IN 46203

Mailing address

PO Box 3299
Carson City, NV 89702-3299
Phone (775) 222-0044

Other identifiers 1

IdentifierTypeStateIssuer
300011112MedicaidIN

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
I20180205002360 IN Practitioner - Nurse Practitioner 7810257177 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
May accept Medicare assignment
Group practices
Post Acute Medical PLLCGroup PAC ID 5193156115, 433 clinicians
Altea Medical Indiana PCGroup PAC ID 4183064389, 24 clinicians

Practice addresses (Care Compare)

1101 E Coolspring Ave
Michigan City, IN 46360-6310
Phone (877) 883-9430

2350 Taft St
Gary, IN 46404-3349
Phone (219) 977-2600

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
28191010AINMDRegistered Nurse
71007760AINMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Post Acute Medical PLLC CurrentSince Jan 30, 2024 Accepting new patients
Advanced Healthcare Associates LLP Adult Health CurrentSince Jan 24, 2018 Accepting new patients
Altea Medical Indiana PC CurrentSince Feb 26, 2024 Accepting new patients

Locations

400 E Rivulon Blvd
Ste 103
Gilbert, AZ 85297

4171 Forest Point Cir
Avon, IN 46123
Phone (317) 745-5184

2300 Parkview Ln
Elwood, IN 46036
Phone (765) 203-2672

2350 Taft St
Gary, IN 46404
Phone (219) 944-2677

3834 S Emerson Ave
Ste C
Indianapolis, IN 46203
Phone (317) 782-1577

5150 Shelbyville Rd
Indianapolis, IN 46237
Phone (317) 782-1577

3518 S Lafountain St
#3803
Kokomo, IN 46902
Phone (765) 453-4667

1101 E Coolspring Ave
Michigan City, IN 46360
Phone (219) 874-5211

981 Beechwood Ave
Middletown, IN 47356
Phone (765) 354-2278

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1485216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533168000000",
    "number": "1114464575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3299",
            "city": "CARSON CITY",
            "state": "NV",
            "postal_code": "897023299",
            "telephone_number": "775-222-0044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3834 S EMERSON AVE",
            "address_2": "BLDG C STE 100",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "46203",
            "telephone_number": "317-782-1577",
            "fax_number": "888-366-7577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BORIS",
        "first_name": "ABIGAIL",
        "middle_name": "G",
        "name_prefix": "Mrs.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-01-24",
        "last_updated": "2018-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "IN",
            "license": "71007760A",
            "primary": true
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "IN",
            "license": "71007760A",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IN",
            "license": "28191010A",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300011112",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.