Individual provider Active NPI

Alexandra Sanserino, FNP-BC

  • Family Nurse Practitioner
  • Fishers, IN
National Provider Identifier
1184170573
Registry record updated Jan 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
71006497A Issued in IN
Practice address
9894 E 121St St
Fishers, IN 46037-4154
Phone
(317) 621-2273
Fax
(317) 806-1653
NPI assigned
Aug 26, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2023

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 71006497A IN Primary

Addresses

Primary practice location

9894 E 121St St
Fishers, IN 46037-4154

Mailing address

6626 E 75TH St Ste 500
Indianapolis, IN 46250-2890

Other practice location 1

1545 N Meridian St
Indianapolis, IN 46202-2306
Phone (317) 923-1491

Other practice location 2

7150 Clearvista Dr
Indianapolis, IN 46256-1695
Phone (317) 621-6161

Other identifiers 3

IdentifierTypeStateIssuer
266180H69OtherINMEDICARE
201395490MedicaidIN
Q00237621OtherINMEDICARE RAILROAD

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
I20161013000706 IN Practitioner - Nurse Practitioner 8022306752 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Physicians of Indiana IncGroup PAC ID 1759416662, 1,569 clinicians

Practice addresses (Care Compare)

9894 E 121St St
Fishers, IN 46037-4154
Phone (317) 621-6060

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Cleanslate Medical Group of Indiana LLC CurrentSince Jul 23, 2018 Accepting new patients
Community Physicians of Indiana Inc CurrentSince Jun 1, 2021 Accepting new patients
Community Physicians of Indiana Inc CurrentSince Jun 1, 2021 Accepting new patients

Locations

5819 Reliable Pkwy
Chicago, IL 60686

4925 S Scatterfield Rd
Anderson, IN 46013
Phone (765) 442-0402

9894 E 121st St
Fishers, IN 46037
Phone (317) 621-2273

6626 E 75th St
Ste 500
Indianapolis, IN 46250
Phone (317) 621-7547

7150 Clearvista Dr
Indianapolis, IN 46256
Phone (317) 355-5041

1545 N Meridian St
Indianapolis, IN 46202
Phone (317) 850-7158

7120 Clearvista Dr
Ste 4000
Indianapolis, IN 46256
Phone (317) 621-7444

Interoperability endpoints

  • Direct secure messaging: asanserino482789@ecommunitydirect.com

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 and National Provider Directory roles.

Hospital & facility affiliations 3

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": "1472169600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673481600000",
    "number": "1184170573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6626 E 75TH ST STE 500",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462502890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9894 E 121ST ST",
            "city": "FISHERS",
            "state": "IN",
            "postal_code": "460374154",
            "telephone_number": "317-621-2273",
            "fax_number": "317-806-1653"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1545 N Meridian St",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462022306",
            "country_code": "US",
            "telephone_number": "317-923-1491",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7150 Clearvista Dr",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462561695",
            "country_code": "US",
            "telephone_number": "317-621-6161",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SANSERINO",
        "first_name": "ALEXANDRA",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-26",
        "last_updated": "2023-01-12",
        "certification_date": "2023-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71006497A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "266180H69",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201395490",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "Q00237621",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fishers, IN

Sources for this page

Verify at the official NPI Registry.