Individual provider Active NPI

Catherine Rose Lara, NURSE PRACTITIONER

  • Nurse Practitioner
  • Crown Point, IN
National Provider Identifier
1841649480
Registry record updated Jan 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
71009690A Issued in IN
Practice address
12750 St Francis Dr Ste 320
Crown Point, IN 46307-0264
Phone
(219) 662-0077
Fax
(219) 662-9496
NPI assigned
Jun 4, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 209014104 IL
Nurse Practitioner 363L00000X 71009690A IN Primary

Addresses

Primary practice location

12750 St Francis Dr Ste 320
Crown Point, IN 46307-0264

Mailing address

PO Box 781076
Detroit, MI 48278-1076
Phone (317) 528-4800

Other practice location 1

9401 S Pulaski Rd
Evergreen Park, IL 60805-1924
Phone (708) 425-6225

Other practice location 2

1205 S Main St Ste 101
Crown Point, IN 46307-3677
Phone (219) 662-0077

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address clara244496@Direct.FranciscanAlliance.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, IN2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20160624000538 IL Practitioner - Nurse Practitioner 5799076519 Reassigns benefits to 4 organizations
I20200329000620 IN Practitioner - Nurse Practitioner 5799076519 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Franciscan Physician NetworkGroup PAC ID 3072790682, 1,152 clinicians

Practice addresses (Care Compare)

1205 S Main St
Suite 101
Crown Point, IN 46307-3677
Phone (219) 662-0077

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
71009690AINMDNurse Practitioner
209014104ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Franciscan Physician Network CurrentSince Mar 20, 2020 Accepting new patients
Franciscan Physician Network CurrentSince Mar 20, 2020 Accepting new patients
Eaves Health Partners PLLC CurrentSince Jun 1, 2023 Accepting new patients
Sandeep Chandra MD SC CurrentSince Jun 5, 2023 Accepting new patients
St Steven Medical Center LTD CurrentSince Jun 27, 2016 Accepting new patients
Vitae Health Medical Illinois, PLLC CurrentSince Aug 16, 2023 Accepting new patients

Locations

5331 W 79th St
Burbank, IL 60459
Phone (704) 422-9577

303 E Wacker Dr
Ste 1127
Chicago, IL 60601
Phone (312) 328-2347

35318 Eagle Way
Chicago, IL 60678

333 Dixie Hwy
Chicago Hts, IL 60411
Phone (708) 756-0100

9401 S Pulaski Rd
Ste 203
Evergreen Pk, IL 60805
Phone (708) 425-6225

940 Maple Rd
Homewood, IL 60430
Phone (708) 799-0244

3800 W 203rd St
Ste 204
Olympia Fields, IL 60461
Phone (708) 679-2670

3700 W 203rd St
Ste 301
Olympia Flds, IL 60461
Phone (708) 679-2850

5151 Church St
Skokie, IL 60077
Phone (773) 436-6600

3450 Oakton St
Ste 300
Skokie, IL 60076

1704 Lafayette Rd
Ste 4
Crawfordsvlle, IN 47933
Phone (765) 364-3120

1205 S Main St
Ste 101
Crown Point, IN 46307
Phone (219) 662-0077

12750 Saint Francis Dr
Ste 320
Crown Point, IN 46307
Phone (219) 662-0077

150 W Washington St
Shelbyville, IN 46176
Phone (317) 392-3211

Organizations & group practices 6

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": "1464998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705017600000",
    "number": "1841649480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 781076",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482781076",
            "telephone_number": "317-528-4800",
            "fax_number": "317-865-1479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12750 ST FRANCIS DR STE 320",
            "city": "CROWN POINT",
            "state": "IN",
            "postal_code": "463070264",
            "telephone_number": "219-662-0077",
            "fax_number": "219-662-9496"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9401 S Pulaski Rd",
            "address_purpose": "LOCATION",
            "city": "Evergreen Park",
            "state": "IL",
            "postal_code": "608051924",
            "country_code": "US",
            "telephone_number": "708-425-6225",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1205 S Main St Ste 101",
            "address_purpose": "LOCATION",
            "city": "Crown Point",
            "state": "IN",
            "postal_code": "463073677",
            "country_code": "US",
            "telephone_number": "219-662-0077",
            "fax_number": "219-681-6701",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LARA",
        "first_name": "CATHERINE",
        "middle_name": "ROSE",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-04",
        "last_updated": "2024-01-12",
        "certification_date": "2024-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209014104",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IN",
            "license": "71009690A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "clara244496@Direct.FranciscanAlliance.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1205 S Main St Ste 101",
            "city": "Crown Point",
            "state": "IN",
            "country_code": "US",
            "postal_code": "463073677",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Crown Point, IN

Sources for this page

Verify at the official NPI Registry.