Individual provider Active NPI

Jennifer J Sabuda, FNP-BC

  • Family Nurse Practitioner
  • Merrillville, IN
National Provider Identifier
1174830236
Registry record updated Sep 9, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
28164729A Issued in IN
Practice address
7863 Broadway Ste 140
Merrillville, IN 46410-5563
Phone
(219) 769-3678
Fax
(219) 736-5638
NPI assigned
Sep 9, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2010

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 28164729A IN Primary

Addresses

Primary practice location

7863 Broadway Ste 140
Merrillville, IN 46410-5563

Mailing address

7863 Broadway Ste 140
Merrillville, IN 46410-5563
Phone (219) 769-3678

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
I20101102001059 IN Practitioner - Nurse Practitioner 2163616210 Reassigns benefits to 2 organizations

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
Northwest Cancer Centers PCGroup PAC ID 4587553474, 26 clinicians

Practice addresses (Care Compare)

3800 Saint Mary Rd
Suite 302
Valparaiso, IN 46383-3986
Phone (219) 464-1620

Hospital & facility affiliations

  • St Mary Medical Center Inc Hospital, Hobart, IN, CCN 150034
  • Franciscan Health Michigan City Hospital, Michigan City, IN, CCN 150015
  • Northwest Health-la Porte Hospital, La Porte, IN, CCN 150006
  • Northwest Health - Porter Hospital, Valparaiso, IN, CCN 150035
  • Northwest Health - Starke Hospital, Knox, IN, CCN 150102

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
28164729AINMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Northwest Cancer Centers, PC CurrentSince Jul 15, 2024 Accepting new patients
Community Care Network Inc CurrentSince Dec 1, 2015 Accepting new patients

Locations

10191 Broadway
#200
Crown Point, IN 46307
Phone (219) 924-8178

342 E 109th Ave
Crown Point, IN 46307
Phone (219) 310-2550

1001 Calumet Ave
Dyer, IN 46311
Phone (219) 924-8178

1600 S Lake Park Ave
Ste 1101
Hobart, IN 46342
Phone (219) 947-1795

1400 S Lake Park Ave
Ste 304
Hobart, IN 46342
Phone (219) 947-6638

1331 State St
Ste 270
La Porte, IN 46350
Phone (219) 236-0943

1331 State St
Ste 240
La Porte, IN 46350
Phone (219) 326-0943

9235 Broadway
Merrillville, IN 46410
Phone (219) 738-2255

7863 Broadway
Ste 140
Merrillville, IN 46410
Phone (219) 769-3678

5510 Franklin St
Michigan City, IN 46360
Phone (219) 809-2600

9130 Columbia Ave
Ste A
Munster, IN 46321
Phone (219) 365-1166

3800 Saint Mary Rd
Ste 302
Valparaiso, IN 46383
Phone (219) 464-1620

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 7

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": "1283990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1283990400000",
    "number": "1174830236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7863 BROADWAY STE 140",
            "city": "MERRILLVILLE",
            "state": "IN",
            "postal_code": "464105563",
            "telephone_number": "219-769-3678",
            "fax_number": "219-736-5638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7863 BROADWAY STE 140",
            "city": "MERRILLVILLE",
            "state": "IN",
            "postal_code": "464105563",
            "telephone_number": "219-769-3678",
            "fax_number": "219-736-5638"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SABUDA",
        "first_name": "JENNIFER",
        "middle_name": "J",
        "name_prefix": "Ms.",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-09",
        "last_updated": "2010-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "28164729A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Merrillville, IN

Sources for this page

Verify at the official NPI Registry.