Individual provider Active NPI

Angela Sue Hayes, ATC, PA-C

  • Physician Assistant
  • Bloomington, IN
National Provider Identifier
1609016997
Registry record updated Feb 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
10002758A Issued in IN
Practice address
2605 E Creeks Edge Dr
Bloomington, IN 47401-8368
Phone
(812) 333-2663
NPI assigned
Feb 25, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X 050302104 IN
Physician Assistant 363A00000X 20206 CA
Physician Assistant 363A00000X 10002758A IN Primary

Addresses

Primary practice location

2605 E Creeks Edge Dr
Bloomington, IN 47401-8368

Mailing address

250 N Shadeland Ave
Indianapolis, IN 46219-4959

Other identifiers 3

IdentifierTypeStateIssuer
090540457OtherINMEDICARE
100167000MedicaidIN
Q00263580OtherINRAILROAD MEDICARE

Other names 1

  • Angela Sue White Other name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ahayes@direct.iuhealth.org Direct

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
I20191008001271 IN Practitioner - Physician Assistant 6608921796 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Iu Health Medical Group LLCGroup PAC ID 9638617913, 4,382 clinicians
Indiana University Health Southern Indiana Physicians LLCGroup PAC ID 6204748197, 474 clinicians

Practice addresses (Care Compare)

1701 N Senate Blvd
Indianapolis, IN 46202-1239
Phone (888) 484-3258

2605 E Creeks Edge Dr
Indiana University So in Phy Inc
Bloomington, IN 47401-8368
Phone (888) 484-3258

2651 E Discovery Pkwy
Bloomington, IN 47408-9059
Phone (812) 353-9250

707 W 2ND St
Bloomington, IN 47403-2209
Phone (888) 484-3258

719 W 2ND St
Bloomington, IN 47403-2209
Phone (888) 484-3258

727 W 2ND St
Bloomington, IN 47403-2209
Phone (888) 484-3258

Hospital & facility affiliations

  • Indiana University Health Bloomington Hospital Hospital, Bloomington, IN, CCN 150051

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
050302104INMDAthletic Trainer
20206CAMDPhysician Assistant
10002758AINMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Iu Health Medical Group, LLC Physician Assistant CurrentSince Jan 1, 2026 Accepting new patients
Indiana University Health Southern Indiana Physicians, LLC Physician Assistant CurrentSince Jul 27, 2019 Accepting new patients
Indiana University Health Southern Indiana Physicians LLC CurrentSince Jul 27, 2019 Accepting new patients

Locations

727 W 2nd St
Bloomington, IN 47403
Phone (812) 353-3450

2605 E Creeks Edge Dr
Bloomington, IN 47401
Phone (812) 333-2663

250 N Shadeland Ave
Indianapolis, IN 46219
Phone (317) 948-9174

1701 Senate Blvd
Indianapolis, IN 46202
Phone (317) 612-2754

Interoperability endpoints

  • Direct secure messaging: awhite55@direct.iuhealth.org

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.

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": "1235520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675900800000",
    "number": "1609016997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 N SHADELAND AVE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462194959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2605 E CREEKS EDGE DR",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474018368",
            "telephone_number": "812-333-2663"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAYES",
        "first_name": "ANGELA",
        "middle_name": "SUE",
        "credential": "ATC, PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-02-25",
        "last_updated": "2023-02-09",
        "certification_date": "2023-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "IN",
            "license": "050302104",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "20206",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IN",
            "license": "10002758A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "090540457",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100167000",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "Q00263580",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ahayes@direct.iuhealth.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2605 E Creeks Edge Dr",
            "city": "Bloomington",
            "state": "IN",
            "country_code": "US",
            "postal_code": "474018368",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "ANGELA",
            "last_name": "WHITE",
            "middle_name": "SUE",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Bloomington, IN

Sources for this page

Verify at the official NPI Registry.