Individual provider Active NPI

Sarah Sue Humes, FNP

  • Family Nurse Practitioner
  • South Bend, IN
National Provider Identifier
1962902254
Registry record updated Mar 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
28167297A Issued in IN
Practice address
211 N Eddy St
South Bend, IN 46617
Phone
(574) 237-9231
Fax
(574) 204-6355
NPI assigned
Feb 13, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2019

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 28167297A IN Primary
Registered Nurse 163W00000X 28167297A IN

Addresses

Primary practice location

211 N Eddy St
South Bend, IN 46617

Mailing address

211 N Eddy St
South Bend, IN 46617-2808
Phone (574) 237-9231

Other practice location 1

3005 Grape Rd
Mishawaka, IN 46545-2708
Phone (574) 255-9555

Other practice location 2

3005 Grape Rd
Mishawaka, IN 46545-2708
Phone (574) 255-9555

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
I20190315000969 IN Practitioner - Nurse Practitioner 3476893165 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Illinois Dermatology Institute, LLCGroup PAC ID 7911043054, 51 clinicians

Practice addresses (Care Compare)

1550 S Woodland Ave
Michigan City, IN 46360-7125
Phone (219) 878-5020

Hospital & facility affiliations

  • Franciscan Health Michigan City Hospital, Michigan City, IN, CCN 150015

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
28167297AINMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Illinois Dermatology Institute, LLC CurrentSince Dec 1, 2022 Accepting new patients
Northern Indiana Dermatology and Skin Surgery Center Past Accepting new patients

Locations

2622 Momentum Pl
Chicago, IL 60689

425 Sand Creek Dr
Chesterton, IN 46304
Phone (219) 395-9353

11061 Broadway
#B
Crown Point, IN 46307
Phone (219) 232-9209

1550 S Woodland Ave
Michigan City, IN 46360
Phone (219) 878-5020

3190 Lancer St
Portage, IN 46368
Phone (219) 764-3600

Interoperability endpoints

  • Direct secure messaging: shumes@illinois.emadirect.md

Organizations & group practices 2

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 2

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": "1518480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552003200000",
    "number": "1962902254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 N EDDY ST",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466172808",
            "telephone_number": "574-237-9231",
            "fax_number": "574-204-6355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 N EDDY ST",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "46617",
            "telephone_number": "574-237-9231",
            "fax_number": "574-204-6355"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3005 Grape Rd",
            "address_purpose": "LOCATION",
            "city": "Mishawaka",
            "state": "IN",
            "postal_code": "465452708",
            "country_code": "US",
            "telephone_number": "574-255-9555",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3005 Grape Rd",
            "address_purpose": "LOCATION",
            "city": "Mishawaka",
            "state": "IN",
            "postal_code": "465452708",
            "country_code": "US",
            "telephone_number": "574-255-9555",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HUMES",
        "first_name": "SARAH",
        "middle_name": "SUE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-13",
        "last_updated": "2019-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "28167297A",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IN",
            "license": "28167297A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Bend, IN

Sources for this page

Verify at the official NPI Registry.