Individual provider Active NPI

Sarah Elizabeth Pluckebaum, APRN

  • Acute Care Nurse Practitioner
  • Indianapolis, IN
National Provider Identifier
1437592979
Registry record updated Mar 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
71004296A Issued in IN
Practice address
8326 Naab Rd
Indianapolis, IN 46260-1920
Phone
(317) 871-0000
Fax
(316) 871-0010
NPI assigned
Apr 15, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2022

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X COA.17090-NP OH
Family Nurse Practitioner 363LF0000X 71004296A IN
Critical Care Pediatric Nurse Practitioner 363LP0222X 71004296A IN
Acute Care Nurse Practitioner 363LA2100X 71004296A IN Primary

Addresses

Primary practice location

8326 Naab Rd
Indianapolis, IN 46260-1920

Mailing address

8326 Naab Rd
Indianapolis, IN 46260-1920
Phone (317) 871-0000

Other practice location 1

3900 Washington Ave Ste 100
Evansville, IN 47714-0550
Phone (317) 871-0000

Other identifiers 1

IdentifierTypeStateIssuer
200392480JMedicaidIN

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
I20220309001590 IN Practitioner - Nurse Practitioner 3375783020 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
71004296AINMDCritical Care Pediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Innovative Hematology, Inc CurrentSince Mar 12, 2024 Accepting new patients
Indiana Hemophilia & Thrombosis Center, Inc. CurrentSince Mar 7, 2022 Accepting new patients
Major Hospital Past Accepting new patients

Locations

3900 Washington Ave
#100
Evansville, IN 47714
Phone (317) 871-0000

8326 Naab Rd
Indianapolis, IN 46260
Phone (317) 338-7200

Interoperability endpoints

  • Direct secure messaging: sarah.pluckebaum.1@25782.direct.athenahealth.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1365984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646697600000",
    "number": "1437592979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8326 NAAB RD",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462601920",
            "telephone_number": "317-871-0000",
            "fax_number": "316-871-0010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8326 NAAB RD",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462601920",
            "telephone_number": "317-871-0000",
            "fax_number": "316-871-0010"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3900 Washington Ave Ste 100",
            "address_purpose": "LOCATION",
            "city": "Evansville",
            "state": "IN",
            "postal_code": "477140550",
            "country_code": "US",
            "telephone_number": "317-871-0000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PLUCKEBAUM",
        "first_name": "SARAH",
        "middle_name": "ELIZABETH",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-15",
        "last_updated": "2022-03-08",
        "certification_date": "2022-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "OH",
            "license": "COA.17090-NP",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71004296A",
            "primary": false
        },
        {
            "code": "363LP0222X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics, Critical Care",
            "state": "IN",
            "license": "71004296A",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "IN",
            "license": "71004296A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200392480J",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.