Individual provider Active NPI

Sarah Aeavenly Bruno, FNP-C

  • Family Nurse Practitioner
  • Indianapolis, IN
National Provider Identifier
1235895889
Registry record updated Jun 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
71011848A Issued in IN
Practice address
6620 Parkdale PL
Indianapolis, IN 46254-5620
Phone
(317) 415-7373
NPI assigned
Nov 9, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 28, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 71011848A IN
Family Nurse Practitioner 363LF0000X 71011848A IN Primary

Addresses

Primary practice location

6620 Parkdale PL
Indianapolis, IN 46254-5620

Mailing address

6620 Parkdale PL
Indianapolis, IN 46254-5620

Other practice location 1

8240 Naab Rd Ste 360
Indianapolis, IN 46260-1987
Phone (317) 961-6396

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL 23999 Health Information Exchange (HIE)

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
I20220627001455 IN Practitioner - Nurse Practitioner 7113306879 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Vincent Medical Group IncGroup PAC ID 7012047640, 728 clinicians

Practice addresses (Care Compare)

590 Pit Rd
Brownsburg, IN 46112-7830
Phone (317) 456-1100

6620 Parkdale PL
Indianapolis, IN 46254-5620
Phone (317) 415-7373

8433 Harcourt Rd
Suite 100
Indianapolis, IN 46260-2193
Phone (317) 583-7600

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
71011848AINMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
St. Vincent Medical Group, Inc. CurrentSince Jun 27, 2022 Accepting new patients
St. Vincent Medical Group, Inc. Family CurrentSince Jun 27, 2022 Accepting new patients
St Vincent Medical Group Inc Past Accepting new patients

Locations

590 Pit Rd
Brownsburg, IN 46112
Phone (317) 415-6040

6620 Parkdale Pl
Indianapolis, IN 46254
Phone (317) 415-7373

250 W 96th St
#520
Indianapolis, IN 46260
Phone (317) 583-3331

1001 Broad Ripple Ave
Indianapolis, IN 46220
Phone (317) 259-7777

8402 Harcourt Rd
Ste 128
Indianapolis, IN 46260
Phone (317) 338-9355

8433 Harcourt Rd
Ste 100
Indianapolis, IN 46260
Phone (317) 583-7702

8091 Township Line Rd
Ste 105
Indianapolis, IN 46260
Phone (317) 415-8050

Interoperability endpoints

  • Direct secure messaging: sarah.bruno.1@7598.direct.athenahealth.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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1636416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656374400000",
    "number": "1235895889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6620 PARKDALE PL",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462545620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6620 PARKDALE PL",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462545620",
            "telephone_number": "317-415-7373"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8240 Naab Rd Ste 360",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462601987",
            "country_code": "US",
            "telephone_number": "317-961-6396",
            "fax_number": "833-907-2332",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRUNO",
        "first_name": "SARAH",
        "middle_name": "AEAVENLY",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-11-09",
        "last_updated": "2022-06-28",
        "certification_date": "2022-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IN",
            "license": "71011848A",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71011848A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "23999",
            "affiliation": "N",
            "endpointDescription": "Athena EMR",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "8240 Naab Rd Ste 360",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "462601987",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.