Individual provider Active NPI

Sabeena Rana Hubbard, D.O.

  • Pediatrics Physician
  • Lafayette, IN
National Provider Identifier
1124209903
Registry record updated Jul 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
02003852A Issued in IN
Practice address
2600 Ferry St
Lafayette, IN 47904-3055
Phone
(765) 448-8000
Fax
(765) 838-4698
NPI assigned
Nov 20, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X OS10682 FL
Hospitalist Physician 208M00000X 02003852A IN
Pediatrics Physician 208000000X 02003852A IN Primary

Addresses

Primary practice location

2600 Ferry St
Lafayette, IN 47904-3055

Mailing address

250 N Shadeland Ave
Indianapolis, IN 46219-4959

Other identifiers 2

IdentifierTypeStateIssuer
000000714821OtherINANTHEM PROVIDER NUMBER
201022900MedicaidIN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ahubbar1@direct.iuhealth.org

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110629000002 IN Practitioner - Pediatric MedicinePractitioner - Hospitalist 4385718063 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
OS10682FLMDPediatrics Physician
02003852AINMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Arnett Clinic, LLC CurrentSince Jul 1, 2011 Accepting new patients
Arnett Clinic, LLC Current Accepting new patients
Iu Health Medical Group Riley Specialists, LLC Pediatrics CurrentSince Jan 1, 2026 Accepting new patients
Arnett Clinic, LLC Pediatrics CurrentSince Jul 1, 2011 Accepting new patients
Panhandle Emergency Physicians a Div of Sacred Heart Hosp Pensacola Past Accepting new patients

Locations

8016 Reliable Pkwy
Chicago, IL 60686

705 Riley Hospital Dr
Indianapolis, IN 46202
Phone (317) 274-4779

250 N Shadeland Ave
Indianapolis, IN 46219
Phone (317) 948-9174

2600 Greenbush St
Lafayette, IN 47904

2600 Ferry St
Lafayette, IN 47904

Organizations & group practices 5

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": "1195516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657584000000",
    "number": "1124209903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 N SHADELAND AVE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462194959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 FERRY ST",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479043055",
            "telephone_number": "765-448-8000",
            "fax_number": "765-838-4698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUBBARD",
        "first_name": "SABEENA",
        "middle_name": "RANA",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-20",
        "last_updated": "2022-07-12",
        "certification_date": "2022-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "OS10682",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "IN",
            "license": "02003852A",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IN",
            "license": "02003852A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM PROVIDER NUMBER",
            "identifier": "000000714821",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201022900",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ahubbar1@direct.iuhealth.org",
            "affiliation": "N",
            "address_1": "2600 Ferry St",
            "city": "Lafayette",
            "state": "IN",
            "country_code": "US",
            "postal_code": "479043055",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lafayette, IN

Sources for this page

Verify at the official NPI Registry.