Individual provider Active NPI

Andrew J Sonderman, MD

  • Addiction Medicine (Anesthesiology) Physician
  • Indianapolis, IN
National Provider Identifier
1952341604
Registry record updated Oct 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction Medicine (Anesthesiology) PhysicianTaxonomy code 207LA0401X
License
01040428A Issued in IN
Practice address
8102 Clearvista Pkwy
Indianapolis, IN 46256-1661
Phone
(317) 849-8222
NPI assigned
Jun 8, 2006
Last updated
Oct 21, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 01040428 IN
Addiction Medicine (Anesthesiology) Physician 207LA0401X 01040428A IN Primary
Addiction Medicine (Psychiatry & Neurology) Physician 2084A0401X 01040428A IN

Addresses

Primary practice location

8102 Clearvista Pkwy
Indianapolis, IN 46256-1661

Mailing address

6626 E 75TH St Ste 500
Indianapolis, IN 46250-2890

Other practice location 1

2001 W 86th St
Indianapolis, IN 46260-1902
Phone (317) 567-2180

Other identifiers 1

IdentifierTypeStateIssuer
200060540MedicaidIN

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
I20040913000270 IN Practitioner - AnesthesiologyPractitioner - Addiction Medicine 4082681804 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
AnesthesiologyAlso: Addiction Medicine
Education
Indiana University School of Medicine, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Physicians of Indiana IncGroup PAC ID 1759416662, 1,569 clinicians

Practice addresses (Care Compare)

8102 Clearvista Pkwy
Indianapolis, IN 46256-1661
Phone (317) 849-8222

Hospital & facility affiliations

  • Fairbanks Hospital, Indianapolis, IN, CCN 150179

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01040428INMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Fairbanks Hospital, Inc. CurrentSince Aug 28, 2017 Accepting new patients
Community Physicians of Indiana Inc CurrentSince Jul 9, 2021 Accepting new patients
Community Physicians of Indiana Inc CurrentSince Jul 9, 2021 Accepting new patients
Major Hospital Past Accepting new patients
Clearvista Recovery Associates PC PastSince Jan 30, 2008 Accepting new patients

Locations

5819 Reliable Pkwy
Chicago, IL 60686

6626 E 75th St
Ste 500
Indianapolis, IN 46250
Phone (317) 621-7547

7120 Clearvista Dr
Ste 4000
Indianapolis, IN 46256
Phone (317) 621-7444

8102 Clearvista Pkwy
Indianapolis, IN 46256
Phone (317) 572-9319

Interoperability endpoints

  • Direct secure messaging: asonderman172000@ecommunitydirect.com

Organizations & group practices 5

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": "1149724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634774400000",
    "number": "1952341604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6626 E 75TH ST STE 500",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462502890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8102 CLEARVISTA PKWY",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462561661",
            "telephone_number": "317-849-8222"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2001 W 86th St",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462601902",
            "country_code": "US",
            "telephone_number": "317-567-2180",
            "fax_number": "317-567-2191",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SONDERMAN",
        "first_name": "ANDREW",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-08",
        "last_updated": "2021-10-21",
        "certification_date": "2021-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IN",
            "license": "01040428",
            "primary": false
        },
        {
            "code": "207LA0401X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Addiction Medicine",
            "state": "IN",
            "license": "01040428A",
            "primary": true
        },
        {
            "code": "2084A0401X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Addiction Medicine",
            "state": "IN",
            "license": "01040428A",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200060540",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.