Individual provider Active NPI

Amy J Kaissar, MD

  • Internal Medicine Physician
  • Indianapolis, IN
National Provider Identifier
1780652172
Registry record updated Jul 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
01045607A Issued in IN
Practice address
8424 Naab Rd Ste 2a
Indianapolis, IN 46260-1966
Phone
(317) 415-6300
NPI assigned
Mar 10, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 01045607A IN Primary

Addresses

Primary practice location

8424 Naab Rd Ste 2a
Indianapolis, IN 46260-1966

Mailing address

8424 Naab Rd Ste 2a
Indianapolis, IN 46260-1966

Other identifiers 1

IdentifierTypeStateIssuer
200148390MedicaidIN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address amy.kaissar.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
I20041207000967 IN Practitioner - Internal Medicine 6608832076 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Yale University School of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
St Vincent Medical Group IncGroup PAC ID 7012047640, 728 clinicians
Sports and Orthopedic Rehabilitation Services IncGroup PAC ID 0840104253, shared by 4 NPIs, 314 clinicians

Practice addresses (Care Compare)

250 W 96TH St
Suite 520
Indianapolis, IN 46260-1317

5347 Main St
Suite 202
New Port Richey, FL 34652-2520
Phone (727) 841-0515

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

Hospital & facility affiliations

  • Ascension St Vincent Hospital Hospital, Indianapolis, IN, CCN 150084
  • Ascension St Vincent Carmel Hospital, Carmel, IN, CCN 150157
  • Ascension St Vincent Fishers Hospital, Fishers, IN, CCN 150181
  • Indiana University Health Hospital, Indianapolis, IN, CCN 150056
  • Hendricks Regional Health Hospital, Danville, IN, CCN 150005
  • Robin Run Health Center Nursing home, Indianapolis, IN, CCN 155505

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
St. Vincent Medical Group, Inc. Internal Medicine CurrentSince Jun 10, 2010 Accepting new patients
Care Group LLC Internal Medicine Past Accepting new patients
Major Hospital Past Accepting new patients
St Vincent Medical Group Inc Past Accepting new patients

Locations

13400 N Meridian St
Ste 304
Carmel, IN 46032
Phone (317) 582-8350

8424 Naab Rd
Ste 2A
Indianapolis, IN 46260
Phone (317) 415-6300

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

8333 Naab Rd
Ste 400
Indianapolis, IN 46260
Phone (317) 338-5066

Interoperability endpoints

  • Direct secure messaging: amy.kaissar.1@7598.direct.athenahealth.com

Organizations & group practices 4

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 7

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": "1141948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657065600000",
    "number": "1780652172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8424 NAAB RD STE 2A",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462601966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8424 NAAB RD STE 2A",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462601966",
            "telephone_number": "317-415-6300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAISSAR",
        "first_name": "AMY",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-10",
        "last_updated": "2022-07-06",
        "certification_date": "2022-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IN",
            "license": "01045607A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200148390",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "amy.kaissar.1@7598.direct.athenahealth.com",
            "affiliation": "Y",
            "affiliationName": "St. Vincent Medical Group, Inc.",
            "address_1": "8424 Naab Rd Ste 2A",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "462601966",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.