Individual provider Active NPI

Kristiana Michelle Sannella, PA-C

  • Surgical Physician Assistant
  • Indianapolis, IN
National Provider Identifier
1790261576
Registry record updated Aug 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
10002520A Issued in IN
Practice address
10590 N Meridian St # 105
Indianapolis, IN 46290
Phone
(317) 583-5400
NPI assigned
Jul 16, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 10002520A IN Primary

Addresses

Primary practice location

10590 N Meridian St # 105
Indianapolis, IN 46290

Mailing address

10590 N Meridian St # 105
Carmel, IN 46290-1028

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kristiana.sannella.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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180831000928 IN Practitioner - Physician Assistant 4082964689 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
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)

10580 N Meridian St
Carmel, IN 46290-1028
Phone (317) 583-5000

10590 N Meridian St
Carmel, IN 46290-1028

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

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
St. Vincent Medical Group, Inc. CurrentSince Aug 12, 2018 Accepting new patients
St. Vincent Medical Group, Inc. CurrentSince Aug 12, 2018 Accepting new patients

Locations

10590 N Meridian St
#105
Carmel, IN 46290
Phone (317) 583-5400

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

Interoperability endpoints

  • Direct secure messaging: kristiana.sannella.1@7598.direct.athenahealth.com

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.

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": "1531699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660521600000",
    "number": "1790261576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10590 N MERIDIAN ST # 105",
            "city": "CARMEL",
            "state": "IN",
            "postal_code": "462901028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10590 N MERIDIAN ST # 105",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "46290",
            "telephone_number": "317-583-5400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANNELLA",
        "first_name": "KRISTIANA",
        "middle_name": "MICHELLE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-16",
        "last_updated": "2022-08-15",
        "certification_date": "2022-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "IN",
            "license": "10002520A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kristiana.sannella.1@7598.direct.athenahealth.com",
            "affiliation": "Y",
            "affiliationName": "St. Vincent Medical Group, Inc.",
            "address_1": "10590 N Meridian St # 105",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "46290",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.