Sara Ruth Hake, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

71003105A Issued in IN

Practice address

211 N Eddy St
South Bend, IN 46617-2808

Phone

(574) 204-6440

NPI assigned

Sep 17, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 1984

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

The South Bend Clinic LLCGroup PAC ID 3779577937, 171 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Northwest Health-la Porte Hospital, La Porte, IN, CCN 150006

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: shake253560@dulyhealthandcare.direct-ci.com
• FHIR API: https://epicproxy.et1296.epichosted.com/APIProxyPRD/api/FHIR/R4/

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.

• The South Bend Clinic LLC

  • Clinic/Center
  • South Bend, IN
  • NPI 1073680419
  Medicare reassignment Care Compare group NPD
• The South Bend Clinic, LLC

  • Anesthesiology Physician
  • South Bend, IN
  • NPI 1487307492
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• La Porte Hospital Company LLC

  • General Acute Care Hospital
  • La Porte, IN
  • NPI 1750746285
  Care Compare affiliation

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

{
    "created_epoch": "1253145600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463443200000",
    "number": "1679806939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 N EDDY ST",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466172808",
            "telephone_number": "574-204-6440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 N EDDY ST",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466172808",
            "telephone_number": "574-204-6440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAKE",
        "first_name": "SARA",
        "middle_name": "RUTH",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-09-17",
        "last_updated": "2016-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71003105A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tracy Ann Haertling, D.O.
• Alison Haffner, NP
• Charles Frederick Hagenow, M.D.
• Christopher Haggans
• Holly L Hake-Harris, MD
• Brittaney Halbert
• Donna Hales-Teat
• Christopher Charles Hall, M.D.
• Mackenzie Nichole Hall, PHARMD
• Michael John Hall, M.D.

• Family Nurse Practitioner in South Bend, IN
• Providers in South Bend, IN by specialty
• Family Nurse Practitioner in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2016; 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.

Verify at the official NPI Registry.