Individual provider Active NPI

Saneera Ilmudeen, MD

  • Family Medicine Physician
  • Greenwood, IN
National Provider Identifier
1720060643
Registry record updated Feb 21, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
10159019A Issued in IN
Practice address
3089 W Fairview Rd
Greenwood, IN 46142-8504
Phone
(317) 881-8700
Fax
(317) 881-9200
NPI assigned
Nov 16, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 10159019A IN Primary

Addresses

Primary practice location

3089 W Fairview Rd
Greenwood, IN 46142-8504

Mailing address

3089 W Fairview Rd
Greenwood, IN 46142-8504
Phone (317) 881-8700

Other identifiers 1

IdentifierTypeStateIssuer
200198380MedicaidIN

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
I20041014000817 IN Practitioner - Family Practice 8921068891 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hancock Physician Network LLCGroup PAC ID 8325952633, 139 clinicians

Practice addresses (Care Compare)

801 N State
Greenfield, IN 46140-1270

801 N State St
Greenfield, IN 46140-1270

801 N State St 3
Central Indiana Amg Specialty Hospital
Greenfield, IN 46140-1270
Phone (317) 477-6789

8535 N Clearview Dr
McCordsville, IN 46055-6241

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
10159019AINMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hancock Physician Network, LLC Family Medicine CurrentSince Jan 6, 2014 Accepting new patients
Major Hospital Past Accepting new patients

Locations

801 N State St
Ste 2000
Greenfield, IN 46140
Phone (317) 325-2727

1 Memorial Sq
Ste 50
Greenfield, IN 46140
Phone (317) 468-6257

8535 N Clearview Dr
Ste 200
McCordsville, IN 46055
Phone (317) 335-6960

Organizations & group practices 2

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": "1132099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329782400000",
    "number": "1720060643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3089 W FAIRVIEW RD",
            "city": "GREENWOOD",
            "state": "IN",
            "postal_code": "461428504",
            "telephone_number": "317-881-8700",
            "fax_number": "317-881-9200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3089 W FAIRVIEW RD",
            "city": "GREENWOOD",
            "state": "IN",
            "postal_code": "461428504",
            "telephone_number": "317-881-8700",
            "fax_number": "317-881-9200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ILMUDEEN",
        "first_name": "SANEERA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-16",
        "last_updated": "2012-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "10159019A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200198380",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenwood, IN

Sources for this page

Verify at the official NPI Registry.