Individual provider Active NPI

Sara Mae Stout, NP-C

  • Family Nurse Practitioner
  • Fort Wayne, IN
National Provider Identifier
1265041016
Registry record updated Nov 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
71010502A Issued in IN
Practice address
7956 W Jefferson Blvd
Fort Wayne, IN 46804-4140
Phone
(260) 436-2416
Fax
(260) 436-6936
NPI assigned
Jul 28, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 71010502A IN Primary
Family Nurse Practitioner 363LF0000X 28214322A IN

Addresses

Primary practice location

7956 W Jefferson Blvd
Fort Wayne, IN 46804-4140

Mailing address

250 N Shadeland Ave
Indianapolis, IN 46219-4959

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address sstout@direct.iuhealth.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
I20201120001657 IN Practitioner - Nurse Practitioner 7113338211 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Iu Health Medical Group LLCGroup PAC ID 9638617913, 4,382 clinicians

Practice addresses (Care Compare)

1701 N Senate Blvd
Indianapolis, IN 46202-1239
Phone (888) 484-3258

Hospital & facility affiliations

  • Lutheran Hospital of Indiana Hospital, Fort Wayne, IN, CCN 150017
  • Bluffton Regional Medical Center Hospital, Bluffton, IN, CCN 150075
  • Parkview Regional Medical Center Hospital, Fort Wayne, IN, CCN 150021

Merit-based Incentive Payment System (MIPS)

Final score
50.34 of 100Reported as group
Quality
41.58
Promoting interoperability
0
Improvement activities
40
Cost
73.15

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
28214322AINMDFamily Nurse Practitioner
71010502AINMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Allied Physicians Inc CurrentSince Oct 22, 2020 Accepting new patients
Indiana University Health Fort Wayne Physicians, LLC CurrentSince Dec 1, 2023 Accepting new patients
Iu Health Medical Group, LLC Family CurrentSince Oct 1, 2025 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

4105 Dicke Rd
Fort Wayne, IN 46804
Phone (260) 268-1000

7956 W Jefferson Blvd
Fort Wayne, IN 46804

256 E Pettit Ave
Ste 100
Fort Wayne, IN 46806

7230 Engle Rd
Ste 100
Fort Wayne, IN 46804
Phone (317) 620-0232

2520 E DuPont Rd
Fort Wayne, IN 46825
Phone (219) 407-8000

2512 E DuPont Rd
Ste 120
Fort Wayne, IN 46825
Phone (260) 490-3323

11109 Parkview Plaza Dr
Fort Wayne, IN 46845
Phone (260) 266-2020

7950 W Jefferson Blvd
Fort Wayne, IN 46804
Phone (260) 434-7088

1701 Senate Blvd
Indianapolis, IN 46202
Phone (317) 612-2754

250 N Shadeland Ave
Indianapolis, IN 46219
Phone (317) 948-9174

10101 Ernst Rd
Roanoke, IN 46783
Phone (260) 234-5401

Interoperability endpoints

  • Direct secure messaging: sstout@direct.iuhealth.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 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": "1595894400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698883200000",
    "number": "1265041016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 N SHADELAND AVE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462194959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7956 W JEFFERSON BLVD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468044140",
            "telephone_number": "260-436-2416",
            "fax_number": "260-436-6936"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOUT",
        "first_name": "SARA",
        "middle_name": "MAE",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-28",
        "last_updated": "2023-11-02",
        "certification_date": "2023-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71010502A",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "28214322A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sstout@direct.iuhealth.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "7956 W Jefferson Blvd",
            "city": "Fort Wayne",
            "state": "IN",
            "country_code": "US",
            "postal_code": "468044140",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

Verify at the official NPI Registry.