NPIMap

Individual provider Active NPI

Staci L Hollar

  • Geriatric Medicine (Internal Medicine) Physician
  • Indianapolis, IN
National Provider Identifier
1366718405
Registry record updated Jun 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
License
01076248A Issued in IN
Practice address
8424 Naab Rd Ste 1L
Indianapolis, IN 46260-1954
Phone
(317) 338-7780
NPI assigned
Mar 22, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 01076248A IN
Student in an Organized Health Care Education/Training Program 390200000X
Geriatric Medicine (Internal Medicine) Physician 207RG0300X 01076248A IN Primary

Addresses

Primary practice location

8424 Naab Rd Ste 1L
Indianapolis, IN 46260-1954

Mailing address

8424 Naab Rd Ste 1L
Indianapolis, IN 46260-1954

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address staci.hollar.2@7598.direct.athenahealth.com St. Vincent Medical Group, Inc.

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160624001574 IN Practitioner - Geriatric MedicinePractitioner - Internal Medicine 5698909950 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Geriatric MedicineAlso: Internal Medicine
Education
Indiana University School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Select Rehabilitation, LLCGroup PAC ID 9032020490, 1,935 clinicians
St Vincent Medical Group IncGroup PAC ID 7012047640, 728 clinicians

Practice addresses (Care Compare)

2600 Compass Rd
Glenview, IL 60026-8001

8424 Naab Rd
Suite 1H
Indianapolis, IN 46260-1954
Phone (317) 338-8680

Hospital & facility affiliations

  • Ascension at Home Home health agency, Indianapolis, IN, CCN 157083
  • Paradigm Health Hospice, Indianapolis, IN, CCN 151611
  • Ascension St Vincent Hospital Hospital, Indianapolis, IN, CCN 150084
  • Ascension St Vincent Fishers Hospital, Fishers, IN, CCN 150181
  • Indiana University Health Ball Memorial Hospital Hospital, Muncie, IN, CCN 150089
  • Ascension St Vincent Carmel Hospital, Carmel, IN, CCN 150157
  • Iu Health West Hospital Hospital, Avon, IN, CCN 150158
  • St Augustine Home for the Aged Nursing home, Indianapolis, IN, CCN 155825

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue32

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
01076248AINMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Major Hospital Past Accepting new patients
St Vincent Medical Group Inc Past Accepting new patients

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 9

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": "1332374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656547200000",
    "number": "1366718405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8424 NAAB RD STE 1L",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462601954"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8424 NAAB RD STE 1L",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462601954",
            "telephone_number": "317-338-7780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLAR",
        "first_name": "STACI",
        "middle_name": "L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-22",
        "last_updated": "2022-06-30",
        "certification_date": "2022-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IN",
            "license": "01076248A",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "IN",
            "license": "01076248A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "staci.hollar.2@7598.direct.athenahealth.com",
            "affiliation": "Y",
            "affiliationName": "St. Vincent Medical Group, Inc.",
            "address_1": "8424 Naab Rd Ste 1L",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "462601954",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.