Active NPI
Anna Marie Restivo, PA-C
- Physician Assistant
- Indianapolis, IN
National Provider Identifier
1568280279
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 10004562A
- Practice address
- 7150 Clearvista Dr
Indianapolis, IN 46256-1695 - Phone
- (317) 355-5041
- NPI assigned
- Oct 1, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 10004562A | IN | |
| Physician Assistant | 363A00000X | 10004562A | IN | Primary |
Addresses
Primary practice location
7150 Clearvista Dr
Indianapolis, IN 46256-1695
Mailing address
6626 E 75TH St Ste 500
Indianapolis, IN 46250-2890
Other practice location 1
1500 N Ritter Ave
Indianapolis, IN 46219-3027
Phone (317) 355-5041
Other practice location 2
1402 E County Line Rd
Indianapolis, IN 46227-0963
Phone (317) 355-5041
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10004562A | IN | MD | Emergency Medicine Physician |
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.
-
- Emergency Medicine Physician
- Indianapolis, IN
- NPI 1710932736
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1727740800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1788393600000",
"number": "1568280279",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6626 E 75TH ST STE 500",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462502890"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7150 CLEARVISTA DR",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462561695",
"telephone_number": "317-355-5041"
}
],
"practiceLocations": [
{
"address_1": "1500 N Ritter Ave",
"address_purpose": "LOCATION",
"city": "Indianapolis",
"state": "IN",
"postal_code": "462193027",
"country_code": "US",
"telephone_number": "317-355-5041",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1402 E County Line Rd",
"address_purpose": "LOCATION",
"city": "Indianapolis",
"state": "IN",
"postal_code": "462270963",
"country_code": "US",
"telephone_number": "317-355-5041",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "RESTIVO",
"first_name": "ANNA",
"middle_name": "MARIE",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-10-01",
"last_updated": "2026-09-03",
"certification_date": "2026-09-03",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "IN",
"license": "10004562A",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "IN",
"license": "10004562A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Indianapolis, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.