Individual provider Active NPI

Cassidy Kaufman

  • Physician Assistant
  • Indianapolis, IN
National Provider Identifier
1679290373
Registry record updated Jul 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
10003803A Issued in IN
Practice address
7150 Clearvista Dr
Indianapolis, IN 46256-1695
Phone
(317) 621-6262
NPI assigned
Oct 24, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 10003803A 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
Phone (317) 621-7584

Other practice location 1

8550 Naab Rd Ste 200
Indianapolis, IN 46260-2086
Phone (317) 338-9300

Other practice location 2

1500 N Ritter Ave
Indianapolis, IN 46219-3027
Phone (317) 355-1411

Other names 1

  • Cassidy Evanson Former name

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
I20221206000220 IN Practitioner - Physician Assistant 7416326939 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
10003803AINMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Community Physicians of Indiana Inc CurrentSince Dec 1, 2022 Accepting new patients

Locations

5819 Reliable Pkwy
Chicago, IL 60686

7120 Clearvista Dr
Ste 4000
Indianapolis, IN 46256
Phone (317) 621-7444

7150 Clearvista Dr
Indianapolis, IN 46256
Phone (317) 355-5041

6626 E 75th St
Ste 500
Indianapolis, IN 46250
Phone (317) 621-7547

1500 N Ritter Ave
Indianapolis, IN 46219
Phone (317) 355-5041

Interoperability endpoints

  • Direct secure messaging: cevanson543396@ecommunitydirect.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1666569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783987200000",
    "number": "1679290373",
    "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",
            "telephone_number": "317-621-7584"
        },
        {
            "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": "317-621-6262"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8550 Naab Rd Ste 200",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462602086",
            "country_code": "US",
            "telephone_number": "317-338-9300",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1500 N Ritter Ave",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462193027",
            "country_code": "US",
            "telephone_number": "317-355-1411",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KAUFMAN",
        "first_name": "CASSIDY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-24",
        "last_updated": "2026-07-14",
        "certification_date": "2026-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IN",
            "license": "10003803A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CASSIDY",
            "last_name": "EVANSON",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.