Individual provider Active NPI

Katherine Irene Boone

  • Surgical Physician Assistant
  • Indianapolis, IN
National Provider Identifier
1215196241
Registry record updated Mar 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
10001000A Issued in IN
Practice address
5255 E Stop 11 Rd Ste 450
Indianapolis, IN 46237-6342
Phone
(317) 865-4800
Fax
(317) 865-4806
NPI assigned
Jun 5, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 99032721A IN
Surgical Physician Assistant 363AS0400X 10001000A IN Primary

Addresses

Primary practice location

5255 E Stop 11 Rd Ste 450
Indianapolis, IN 46237-6342

Mailing address

PO Box 781076
Detroit, MI 48278-1076
Phone (317) 528-4800

Other identifiers 2

IdentifierTypeStateIssuer
300007527MedicaidIN
M400063087OtherINMEDICARE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kboone7767@Direct.FranciscanAlliance.org Direct

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
I20080716000012 IN Practitioner - Physician Assistant 3870666423 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Franciscan Physician NetworkGroup PAC ID 3072790682, 1,152 clinicians

Practice addresses (Care Compare)

150 W Washington St
Shelbyville, IN 46176-1236
Phone (317) 865-5904

5255 E Stop 11 Rd
Indianapolis, IN 46237-6341

8111 S Emerson Ave
Indianapolis, IN 46237-8601

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
10001000AINMDSurgical Physician Assistant
99032721AINMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Franciscan Physician Network CurrentSince Jan 7, 2012 Accepting new patients
Franciscan Physician Network CurrentSince Jan 7, 2012 Accepting new patients
St. Francis Medical Group, LLC Past Accepting new patients
Mandelbaum Surgical PC Past Accepting new patients

Locations

1704 Lafayette Rd
Ste 4
Crawfordsvlle, IN 47933
Phone (765) 364-3120

1040 Sierra Dr
Ste 400
Greenwood, IN 46143
Phone (317) 528-4886

701 E County Line Rd
Ste 101
Greenwood, IN 46143
Phone (317) 885-2860

8051 S Emerson Ave
Ste 260
Indianapolis, IN 46237
Phone (317) 865-4800

5330 E Stop 11 Rd
Indianapolis, IN 46237
Phone (317) 893-1920

5255 E Stop 11 Rd
Ste 450
Indianapolis, IN 46237
Phone (317) 865-4800

150 W Washington St
Shelbyville, IN 46176
Phone (317) 392-3211

Interoperability endpoints

  • Direct secure messaging: kboone30904@ecommunitydirect.com
  • Direct secure messaging: kboone7767@direct.franciscanalliance.org

Organizations & group practices 4

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.

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": "1212624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679356800000",
    "number": "1215196241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 781076",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482781076",
            "telephone_number": "317-528-4800",
            "fax_number": "317-865-1479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5255 E STOP 11 RD STE 450",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462376342",
            "telephone_number": "317-865-4800",
            "fax_number": "317-865-4806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOONE",
        "first_name": "KATHERINE",
        "middle_name": "IRENE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-05",
        "last_updated": "2023-03-21",
        "certification_date": "2023-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "IN",
            "license": "99032721A",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "IN",
            "license": "10001000A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300007527",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "M400063087",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kboone7767@Direct.FranciscanAlliance.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "5255 E Stop 11 Rd",
            "address_2": "Suite 450",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "462376340",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.