Individual provider Active NPI

Alysen Renee Adams

  • Physician Assistant
  • New Albany, IN
National Provider Identifier
1861961062
Registry record updated Dec 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
4101 Technology Ave
New Albany, IN 47150-8548
Phone
(812) 941-4500
NPI assigned
Nov 16, 2018
Last updated
Dec 17, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X IN Primary

Addresses

Primary practice location

4101 Technology Ave
New Albany, IN 47150-8548

Mailing address

4101 Technology Ave
New Albany, IN 47150-8548
Phone (812) 941-4500

Other names 1

  • Alysen Renee Shireman Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN, KY2 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
I20190405001762 IN Practitioner - Physician Assistant 4880935576 Reassigns benefits to 1 organization
I20260501001225 KY Practitioner - Physician Assistant 4880935576 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
Live Well Orthopedic Care LLCGroup PAC ID 9739416611, 4 clinicians

Practice addresses (Care Compare)

8442 Dixie Hwy
Louisville, KY 40258-1140
Phone (502) 286-4644

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
American Health Network of Indiana LLC CurrentSince Dec 2, 2024 Accepting new patients
American Health Network of Indiana, LLC CurrentSince Dec 2, 2024 Accepting new patients

Locations

10995 Allisonville Rd
Ste 100
Fishers, IN 46038
Phone (317) 842-7928

300 E Boyd Ave
Ste 100
Greenfield, IN 46140
Phone (317) 208-3866

7440 Woodland Dr
Indianapolis, IN 46278
Phone (317) 450-3357

1850 State St
New Albany, IN 47150
Phone (812) 944-7701

4101 Technology Ave
New Albany, IN 47150
Phone (812) 941-4500

Interoperability endpoints

  • Direct secure messaging: aadams211701@direct.optum.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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1542326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734393600000",
    "number": "1861961062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4101 TECHNOLOGY AVE",
            "city": "NEW ALBANY",
            "state": "IN",
            "postal_code": "471508548",
            "telephone_number": "812-941-4500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4101 TECHNOLOGY AVE",
            "city": "NEW ALBANY",
            "state": "IN",
            "postal_code": "471508548",
            "telephone_number": "812-941-4500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADAMS",
        "first_name": "ALYSEN",
        "middle_name": "RENEE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-16",
        "last_updated": "2024-12-17",
        "certification_date": "2024-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALYSEN",
            "last_name": "SHIREMAN",
            "middle_name": "RENEE",
            "credential": "PA-C",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in New Albany, IN

Sources for this page

Verify at the official NPI Registry.