Individual provider Active NPI

Sarah Hafsa Gangadhar, MD

  • Pediatrics Physician
  • Zionsville, IN
National Provider Identifier
1639460298
Registry record updated Jun 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
01073723A Issued in IN
Practice address
10801 N Michigan Rd
Zionsville, IN 46077-8170
Phone
(317) 344-1234
NPI assigned
Apr 29, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 01073723A IN Primary

Addresses

Primary practice location

10801 N Michigan Rd
Zionsville, IN 46077-8170

Mailing address

10801 N Michigan Rd
Zionsville, IN 46077-8170

Other identifiers 2

IdentifierTypeStateIssuer
PO1599186OtherINRR MEDICARE
201099930MedicaidIN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address sarah.gangadhar.1@7598.direct.athenahealth.com St. Vincent Medical Group, Inc.

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160120000100 IN Practitioner - Pediatric Medicine 8123266921 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Indiana University School of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Vincent Medical Group IncGroup PAC ID 7012047640, 728 clinicians

Practice addresses (Care Compare)

14540 Prairie Lakes Blvd N
Suite 200
Noblesville, IN 46060-4370
Phone (317) 578-4193

8433 Harcourt Rd
Suite 100
Indianapolis, IN 46260-2193
Phone (317) 583-7600

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
01073723AINMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St. Vincent Medical Group, Inc. Pediatrics CurrentSince Apr 29, 2019 Accepting new patients
St. Vincent Medical Group, Inc. CurrentSince Apr 29, 2019 Accepting new patients
St Vincent Medical Group Inc Past Accepting new patients

Locations

250 W 96th St
#520
Indianapolis, IN 46260
Phone (317) 583-3331

8433 Harcourt Rd
Ste 100
Indianapolis, IN 46260
Phone (317) 583-7702

10801 N Michigan Rd
Zionsville, IN 46077
Phone (317) 344-1234

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": "1304035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655856000000",
    "number": "1639460298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10801 N MICHIGAN RD",
            "city": "ZIONSVILLE",
            "state": "IN",
            "postal_code": "460778170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10801 N MICHIGAN RD",
            "city": "ZIONSVILLE",
            "state": "IN",
            "postal_code": "460778170",
            "telephone_number": "317-344-1234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GANGADHAR",
        "first_name": "SARAH",
        "middle_name": "HAFSA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-04-29",
        "last_updated": "2022-06-22",
        "certification_date": "2022-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IN",
            "license": "01073723A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "PO1599186",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201099930",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sarah.gangadhar.1@7598.direct.athenahealth.com",
            "affiliation": "Y",
            "affiliationName": "St. Vincent Medical Group, Inc.",
            "address_1": "10801 N Michigan Rd",
            "city": "Zionsville",
            "state": "IN",
            "country_code": "US",
            "postal_code": "460778170",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Zionsville, IN

Sources for this page

Verify at the official NPI Registry.