Individual provider Active NPI

Sandra Lee Rardin, NP-C

  • Family Nurse Practitioner
  • Munster, IN
National Provider Identifier
1306289731
Registry record updated Aug 21, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F1212172 Issued in IN
Practice address
10110 Donald S Powers Drive
Suite 101D
Munster, IN 46321
Phone
(219) 301-7265
Fax
(219) 595-0889
NPI assigned
Apr 16, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 21, 2019

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 F1212172 IN Primary

Addresses

Primary practice location

10110 Donald S Powers Drive
Suite 101D
Munster, IN 46321

Mailing address

PO Box 697
Tinley Park, IL 60477-0697

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
I20131203001842 IN Practitioner - Nurse Practitioner 3870729494 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advanced Care Medical Specialists PCGroup PAC ID 7416251590, 7 clinicians

Practice addresses (Care Compare)

1532 Calumet Ave
Dyer, IN 46311-1588
Phone (219) 515-4700

Hospital & facility affiliations

  • Franciscan Health Crown Point Hospital, Crown Point, IN, CCN 150126

Merit-based Incentive Payment System (MIPS)

Final score
91.08 of 100Reported as group
Quality
90
Improvement activities
40
Cost
66.95

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F1212172INMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Care Medical Specialists, P.C. CurrentSince Oct 29, 2016 Accepting new patients

Locations

10110 Donald S Powers Dr
Munster, IN 46321
Phone (219) 922-8222

10110 Donald S Powers Dr
Ste 101D
Munster, IN 46321
Phone (219) 301-7265

Organizations & group practices 1

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 1

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": "1366070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566345600000",
    "number": "1306289731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 697",
            "city": "TINLEY PARK",
            "state": "IL",
            "postal_code": "604770697",
            "fax_number": "192-595-0889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10110 DONALD S POWERS DRIVE",
            "address_2": "SUITE 101D",
            "city": "MUNSTER",
            "state": "IN",
            "postal_code": "46321",
            "telephone_number": "219-301-7265",
            "fax_number": "219-595-0889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RARDIN",
        "first_name": "SANDRA",
        "middle_name": "LEE",
        "name_prefix": "Ms.",
        "credential": "NP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-04-16",
        "last_updated": "2019-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "F1212172",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Munster, IN

Sources for this page

Verify at the official NPI Registry.