NPIMap

Individual provider Active NPI

Scott K Sanders, MD, PHD

  • Neurology Physician
  • Lafayette, IN
National Provider Identifier
1902800576
Registry record updated Sep 13, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
01045654 Issued in IN
Practice address
3721 Rome Dr
Suite a
Lafayette, IN 47905-4408
Phone
(765) 807-7100
Fax
(765) 807-7101
NPI assigned
Jun 10, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 13, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 01045654 IN Primary

Addresses

Primary practice location

3721 Rome Dr
Suite a
Lafayette, IN 47905-4408

Mailing address

3721 Rome Dr
Suite a
Lafayette, IN 47905-4408
Phone (765) 807-7100

Other identifiers 3

IdentifierTypeStateIssuer
10019219OtherINENCORE
200375760MedicaidIN
000000507081OtherINANTHEM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070501000538 IN Practitioner - NeurologyPractitioner - Ophthalmology 2668578063 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
NeurologyAlso: Ophthalmology
Education
Indiana University School of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Indiana Neuro-Ophthalmology and Center for BalanceGroup PAC ID 2769588151, 2 clinicians

Practice addresses (Care Compare)

3721 Rome Dr
Suite a
Lafayette, IN 47905-4401
Phone (765) 807-7100

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
78.19 of 100Reported as individual
Quality
56.37
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01045654INMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Indiana Neuro-Ophthalmology & Center for Balance Neurology CurrentSince Feb 12, 2007 Accepting new patients
Major Hospital Past Accepting new patients
Josephson-Wallack-Munshower Neurology PC Neurology PastSince May 11, 2025 Accepting new patients

Locations

3721 Rome Dr
Ste A
Lafayette, IN 47905
Phone (765) 807-7100

3721 Rome Dr
Lafayette, IN 47905
Phone (765) 807-7100

Interoperability endpoints

  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.441.1753
  • FHIR API: https://fhir4.healow.com/fhir/r4/CAIFCD
  • FHIR API: https://fhir4.healow.com/fhir/r4/CAIFCD/Endpoint/CAIFCD

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

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": "1118361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1315872000000",
    "number": "1902800576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3721 ROME DR",
            "address_2": "SUITE A",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479054408",
            "telephone_number": "765-807-7100",
            "fax_number": "765-870-7101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3721 ROME DR",
            "address_2": "SUITE A",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479054408",
            "telephone_number": "765-807-7100",
            "fax_number": "765-807-7101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDERS",
        "first_name": "SCOTT",
        "middle_name": "K",
        "credential": "MD, PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-10",
        "last_updated": "2011-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "IN",
            "license": "01045654",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ENCORE",
            "identifier": "10019219",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200375760",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000507081",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lafayette, IN

Sources for this page

Verify at the official NPI Registry.