Individual provider Active NPI

Amanda Michele O'Mara, M.D.

  • Anesthesiology Physician
  • Indianapolis, IN
National Provider Identifier
1174784532
Registry record updated May 28, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
01071034 Issued in IN
Practice address
8111 S Emerson Ave
Indianapolis, IN 46237-8601
Phone
(317) 870-6736
Fax
(317) 870-0499
NPI assigned
Jun 18, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 28, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 01071034 IN Primary
Internal Medicine Physician 207R00000X 11014408A IN

Addresses

Primary practice location

8111 S Emerson Ave
Indianapolis, IN 46237-8601

Mailing address

PO Box 6069 Dept 107
Indianapolis, IN 46206-6069
Phone (317) 870-6736

Other identifiers 4

IdentifierTypeStateIssuer
000000772905OtherINANTHEM
201085250MedicaidIN
M400074668OtherINMEDICARE
P01100799OtherINRAILROAD MEDICARE

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
I20120724000097 IN Practitioner - Anesthesiology 0042476848 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Indiana University School of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southeast Anesthesiologists IncGroup PAC ID 6800837980, 91 clinicians

Practice addresses (Care Compare)

8111 S Emerson Ave
Indianapolis, IN 46237-8601
Phone (317) 528-5000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01071034INMDAnesthesiology Physician
11014408AINMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southeast Anesthesiologists, Inc. Anesthesiology CurrentSince Aug 20, 2012 Accepting new patients

Locations

8111 S Emerson Ave
Indianapolis, IN 46237
Phone (317) 528-5261

Interoperability endpoints

  • Direct secure messaging: aomara95526@direct.franciscanalliance.org

Organizations & group practices 1

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": "1213747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1369699200000",
    "number": "1174784532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6069 DEPT 107",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462066069",
            "telephone_number": "317-870-6736",
            "fax_number": "317-870-0499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8111 S EMERSON AVE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462378601",
            "telephone_number": "317-870-6736",
            "fax_number": "317-870-0499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'MARA",
        "first_name": "AMANDA",
        "middle_name": "MICHELE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-18",
        "last_updated": "2013-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IN",
            "license": "01071034",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IN",
            "license": "11014408A",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000772905",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201085250",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "M400074668",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P01100799",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.