NPIMap

Organization Active NPI

Proactive Clinical Partners

  • Gerontology Nurse Practitioner
  • Indianapolis, IN
National Provider Identifier
1366934242
Registry record updated May 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
Legal business name
PROACTIVE CLINICAL PARTNERS
Practice address
8455 Keystone Xing Ste 300
Indianapolis, IN 46240-4353
Phone
(317) 941-7338
Fax
(317) 969-6727
NPI assigned
Jun 5, 2018
Reactivated
Dec 19, 2025
Last updated
May 14, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 14, 2026

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

Authorized official

Name
Hector Vazquez
Title
Ceo
Phone
(317) 941-7338

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
End-Stage Renal Disease (ESRD) Treatment Clinic/Center 261QE0700X
Gerontology Nurse Practitioner 363LG0600X Primary

Addresses

Primary practice location

8455 Keystone Xing Ste 300
Indianapolis, IN 46240-4353

Mailing address

8455 Keystone Xing Ste 300
Indianapolis, IN 46240-4353
Phone (317) 941-7338

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180718001740 IN Part B Supplier - Clinic/Group Practice 8527315852 Receives reassigned benefits from 48 practitioners
Practice locations: Indianapolis, IN; Lafayette, IN; Lebanon, IN; Liberty, IN; Martinsville, IN; Mooresville, IN; Morristown, IN; Muncie, IN…

National Provider Directory

National Provider Directory

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Locations

1108 Kingwood Dr
Avon, IN 46123
Phone (317) 204-1100

628 N Meridian Rd
Greenfield, IN 46140
Phone (317) 318-0413

2140 W 86th St
Indianapolis, IN 46260
Phone (317) 338-5761

8455 Keystone Xing
Ste 300
Indianapolis, IN 46240
Phone (317) 389-5418

Ownership & related parties

All facility ownership & control disclosures 17

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Carmel Health & Living CommunityCarmel, IN, CCN 155181 Skilled nursing facility Adp of the SNF Jan 1, 2020
Countryside Manor Health & Living CommunityAnderson, IN, CCN 155258 Skilled nursing facility Adp of the SNF Jan 1, 2020
Rawlins House Health & Living CommunityPendleton, IN, CCN 155357 Skilled nursing facility Adp of the SNF Jan 1, 2020
Harbour Manor Health & Living CommunityNoblesville, IN, CCN 155381 Skilled nursing facility Adp of the SNF Jan 1, 2020
Brown County Health & Living CommunityNashville, IN, CCN 155487 Skilled nursing facility Adp of the SNF Jan 1, 2020
Arbor Trace Health & Living CommunityRichmond, IN, CCN 155481 Skilled nursing facility Adp of the SNF Jan 1, 2020
Altenheim Health & Living CommunityIndianapolis, IN, CCN 155196 Skilled nursing facility Adp of the SNF Jan 1, 2020
Morristown ManorMorristown, IN, CCN 155691 Skilled nursing facility Adp of the SNF Jan 1, 2020
Aspen Trace Health & Living CommunityGreenwood, IN, CCN 155821 Skilled nursing facility Adp of the SNF Dec 22, 2020
Cumberland Trace Health & Living CommunityPlainfield, IN, CCN 155836 Skilled nursing facility Adp of the SNF Jan 1, 2020
University Heights Health and Living CommunityIndianapolis, IN, CCN 155327 Skilled nursing facility Adp of the SNF Jan 1, 2020
Copper Trace Health & Living CommunityWestfield, IN, CCN 155841 Skilled nursing facility Adp of the SNF Jan 1, 2020
Greenwood Health and Living CommunityGreenwood, IN, CCN 155412 Skilled nursing facility Adp of the SNF Jan 1, 2020
Bell Trace Health and Living CenterBloomington, IN, CCN 155677 Skilled nursing facility Adp of the SNF Jan 1, 2020
Lincoln Hills of New AlbanyNew Albany, IN, CCN 155614 Skilled nursing facility Adp of the SNF Jan 1, 2020
Envive of MuncieMuncie, IN, CCN 155549 Skilled nursing facility Adp of the SNF Jan 1, 2025
Envive of LibertyLiberty, IN, CCN 155507 Skilled nursing facility Adp of the SNF Jan 1, 2025

Owned or controlled facilities with NPI records 18

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

View all 18

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 51

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 51

NPI Registry JSON

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

{
    "created_epoch": "1528156800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1778716800000",
    "number": "1366934242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8455 KEYSTONE XING STE 300",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462404353",
            "telephone_number": "317-941-7338",
            "fax_number": "317-969-6727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8455 KEYSTONE XING STE 300",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462404353",
            "telephone_number": "317-941-7338",
            "fax_number": "317-969-6727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROACTIVE CLINICAL PARTNERS",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-06-05",
        "last_updated": "2026-05-14",
        "certification_date": "2026-05-14",
        "deactivation_date": "2025-10-10",
        "reactivation_date": "2025-12-19",
        "status": "A",
        "authorized_official_last_name": "VAZQUEZ",
        "authorized_official_first_name": "HECTOR",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "317-941-7338"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.