Active NPI
Angela Sue Hayes, ATC, PA-C
- Physician Assistant
- Bloomington, IN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 10002758A
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 090540457 | Other | IN | MEDICARE |
| 100167000 | Medicaid | IN | |
| Q00263580 | Other | IN | RAILROAD MEDICARE |
Other names 1
- Angela Sue White
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| 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
Enrollment records 1
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
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
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 050302104 | IN | MD | Athletic Trainer |
| 20206 | CA | MD | Physician Assistant |
| 10002758A | IN | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Iu Health Medical Group, LLC | Physician Assistant | Current | Accepting new patients |
| Indiana University Health Southern Indiana Physicians, LLC | Physician Assistant | Current | Accepting new patients |
| Indiana University Health Southern Indiana Physicians LLC | Current | 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
- 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.
-
- Multi-Specialty Clinic/Center
- Bloomington, IN
- NPI 1013953983
Physician Assistant
-
- General Practice Physician
- Indianapolis, IN
- NPI 1326893777
Physician Assistant
-
- Durable Medical Equipment & Medical Supplies
- Bloomington, IN
- NPI 1063179844
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Bloomington, IN
- NPI 1205860335
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2023; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.