Individual provider Active NPI

Adara Simonelli, PA

  • Physician Assistant
  • Dyer, IN
National Provider Identifier
1386278430
Registry record updated Apr 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
10003522A Issued in IN
Practice address
24 Joliet St
Dyer, IN 46311-1705
Phone
(219) 852-1524
Fax
(219) 933-2288
NPI assigned
Feb 27, 2020
Last updated
Apr 21, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 21, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 10003522A IN Primary
Medical Physician Assistant 363AM0700X

Addresses

Primary practice location

24 Joliet St
Dyer, IN 46311-1705

Mailing address

PO Box 781076
Detroit, MI 48278-1076
Phone (317) 528-4800

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL 1234

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, IN2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20201005002102 IL Practitioner - Physician Assistant 6800215203 Reassigns benefits to 1 organization
I20220615002092 IN Practitioner - Physician Assistant 6800215203 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Franciscan Physician NetworkGroup PAC ID 3072790682, 1,152 clinicians

Practice addresses (Care Compare)

150 W Washington St
Shelbyville, IN 46176-1236
Phone (317) 865-5904

1704 Lafayette Rd
Crawfordsville, IN 47933-1071

24 Joliet St
Dyer, IN 46311-1705

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Mount Sinai Community Foundation CurrentSince Sep 25, 2020 Accepting new patients
Franciscan Physician Network CurrentSince Jun 1, 2022 Accepting new patients
Mount Sinai Community Foundation CurrentSince Sep 25, 2020 Accepting new patients
Franciscan Physician Network CurrentSince Jun 1, 2022 Accepting new patients

Locations

26460 Network Pl
Chicago, IL 60673
Phone (708) 786-2900

1704 Lafayette Rd
Ste 4
Crawfordsvlle, IN 47933
Phone (765) 364-3120

24 Joliet St
Dyer, IN 46311
Phone (219) 864-2237

1040 Sierra Dr
Ste 400
Greenwood, IN 46143
Phone (317) 528-4886

5454 Hohman Ave
Hammond, IN 46320
Phone (219) 933-2077

150 W Washington St
Shelbyville, IN 46176
Phone (317) 392-3211

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1582761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745193600000",
    "number": "1386278430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 781076",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482781076",
            "telephone_number": "317-528-4800",
            "fax_number": "317-865-1489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24 JOLIET ST",
            "city": "DYER",
            "state": "IN",
            "postal_code": "463111705",
            "telephone_number": "219-852-1524",
            "fax_number": "219-933-2288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMONELLI",
        "first_name": "ADARA",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-02-27",
        "last_updated": "2025-04-21",
        "certification_date": "2025-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IN",
            "license": "10003522A",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "1234",
            "affiliation": "N",
            "address_1": "24 Joliet St",
            "city": "Dyer",
            "state": "IN",
            "country_code": "US",
            "postal_code": "463111705",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Dyer, IN

Sources for this page

Verify at the official NPI Registry.