Individual provider Active NPI

Kaitlin Eileen Ziedonis, PA-C

  • Physician Assistant
  • Indianapolis, IN
National Provider Identifier
1003402363
Registry record updated Oct 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
10003113A Issued in IN
Practice address
5330 E Stop 11 Rd
Indianapolis, IN 46237-6345
Phone
(317) 893-1900
Fax
(317) 893-1901
NPI assigned
Dec 21, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2023

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 10003113A IN Primary

Addresses

Primary practice location

5330 E Stop 11 Rd
Indianapolis, IN 46237-6345

Mailing address

PO Box 781076
Detroit, MI 48278-1076
Phone (317) 528-4800

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kcoons574037@Direct.FranciscanAlliance.org Direct

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
I20210305000758 IN Practitioner - Physician Assistant 5698181287 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Franciscan Physician NetworkGroup PAC ID 3072790682, 1,152 clinicians

Practice addresses (Care Compare)

150 W Washington St
Shelbyville, IN 46176-1236
Phone (317) 865-5904

1704 Lafayette Rd
Crawfordsville, IN 47933-1071

5330 E Stop 11 Rd
Indianapolis, IN 46237-6345
Phone (317) 893-1900

8111 S Emerson Ave
Indianapolis, IN 46237-8601

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Franciscan Physician Network CurrentSince Jan 17, 2021 Accepting new patients
Franciscan Physician Network CurrentSince Jan 17, 2021 Accepting new patients
Major Hospital Past Accepting new patients

Locations

1704 Lafayette Rd
Ste 4
Crawfordsvlle, IN 47933
Phone (765) 364-3120

1040 Sierra Dr
Ste 400
Greenwood, IN 46143
Phone (317) 528-4886

5330 E Stop 11 Rd
Indianapolis, IN 46237
Phone (317) 893-1920

1201 Hadley Rd
Mooresville, IN 46158
Phone (317) 783-8148

150 W Washington St
Shelbyville, IN 46176
Phone (317) 392-3211

Interoperability endpoints

  • Direct secure messaging: kziedonis574037@direct.franciscanalliance.org
  • Direct secure messaging: kcoons574037@direct.franciscanalliance.org

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 and National Provider Directory roles.

Hospital & facility affiliations 4

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": "1608508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696291200000",
    "number": "1003402363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 781076",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482781076",
            "telephone_number": "317-528-4800",
            "fax_number": "317-865-1479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5330 E STOP 11 RD",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462376345",
            "telephone_number": "317-893-1900",
            "fax_number": "317-893-1901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZIEDONIS",
        "first_name": "KAITLIN",
        "middle_name": "EILEEN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-21",
        "last_updated": "2023-10-03",
        "certification_date": "2023-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IN",
            "license": "10003113A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kcoons574037@Direct.FranciscanAlliance.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "5330 E Stop 11 Rd",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "462376345",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.