MRS. SHAUNA KAY SIDHOM NP
NPI 1104009430
Nurse Practitioner in Indianapolis, IN
About Mrs. Shauna Kay Sidhom Np NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MRS. SHAUNA KAY SIDHOM NP (NPI 1104009430) is an individual nurse practitioner in Indianapolis, Indiana, licensed in Indiana (71002333A) and active in the NPI registry since December 2007. She is enrolled in Medicare PECOS and is a graduate of Other (2006).
NPPES Registry Identity
Specialties & Licenses 2
Other Names 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Mrs. Shauna Kay Sidhom Np is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignments
4Medicare enrollment records show Shauna Sidhom reassigns Medicare billing to 4 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Indianapolis, IN 46202
- Reassigned Medicare billing, Indiana enrollment
Indianapolis, IN 46240
- Reassigned Medicare billing, Indiana enrollment
- 31 clinicians in this Medicare group
Indianapolis, IN 46240
- Reassigned Medicare billing, Indiana enrollment
- 50 clinicians in this Medicare group
Buffalo, NY 14201
- Reassigned Medicare billing, Indiana enrollment
- 30 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 46227 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Shauna Sidhom's NPI number?
The NPI number for Shauna Sidhom is 1104009430. It was assigned to this individual provider in the NPPES registry on December 10, 2007. The provider is also known as Miss Shauna Kay Hollinger Np.
Where is Shauna Sidhom located?
Shauna Sidhom practices at 4026 Madison Ave, Indianapolis, IN 46227. The listed phone number is (317) 788-0396.
What is Shauna Sidhom's specialty?
The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.
Is Shauna Sidhom enrolled in Medicare?
Yes. Shauna Sidhom is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organizations bill Medicare for Shauna Sidhom's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Shauna Sidhom reassigns Medicare benefits to 4 organizations: Affinity Care Of Indiana LLC (Indianapolis, IN), Cinqcare At Home PC (Indianapolis, IN), Grace Divine, LLC (Indianapolis, IN) and Care Medical Practice PLLC (Buffalo, NY). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Shauna Sidhom's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Shauna Sidhom accept?
Health plans from Ambetter Health, Ambetter from Buckeye Health Plan and Ambetter from Meridian list Shauna Sidhom as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Shauna Sidhom was last updated on April 9, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Mrs. Shauna Kay Sidhom, NP · NPI 1104009430
Nurse Practitioner physician in Indianapolis, Indiana. Individual provider, active in the CMS NPPES registry since December 10, 2007.
## Identity
- **NPI:** 1104009430 (Entity type: Individual)
- **Enumerated:** December 10, 2007
- **Primary specialty:** Nurse Practitioner · taxonomy 363L00000X
- **State license:** 71002333A (Indiana)
- **Sole proprietor:** No
## Practice location
- **Address:** 4026 MADISON AVE, Indianapolis, IN 46227
- **Phone:** (317) 788-0396 · **Fax:** (317) 780-0860
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 4 organizations under Medicare reassignment (form CMS-855R): Affinity Care Of Indiana LLC (NPI 1982360350, Indianapolis, IN); Cinqcare At Home PC (NPI 1235736067, Indianapolis, IN); Grace Divine, LLC (NPI 1548596372, Indianapolis, IN); Care Medical Practice PLLC (NPI 1811658883, Buffalo, NY) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2006
## Record status
- **NPPES last updated:** April 9, 2008
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Source: [NPI Profile](https://npiprofile.com/npi/1104009430) · Data from the CMS NPPES public registry.