Individual provider Active NPI

Elizabeth Anne Mysliwiec, FNP

  • Nurse Practitioner
  • Fort Wayne, IN
National Provider Identifier
1013640200
Registry record updated Sep 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
71014932A Issued in IN
Practice address
800 Broadway Ste 100
Fort Wayne, IN 46802-2149
Phone
(260) 425-2630
Fax
(260) 425-2631
NPI assigned
Jul 5, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2025

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 28153761A IN
Nurse Practitioner 363L00000X 71014932A IN Primary

Addresses

Primary practice location

800 Broadway Ste 100
Fort Wayne, IN 46802-2149

Mailing address

800 Broadway Ste 100
Fort Wayne, IN 46802-2149
Phone (260) 425-2630

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address elizabeth.mysliwiec@lutheranhealthnetwork.cernerdirect.com 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
I20240217000351 IN Practitioner - Nurse Practitioner 0749624724 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Fast Pace Medical Clinic PLLCGroup PAC ID 5395881841, 737 clinicians
Lutheran Medical Group LLCGroup PAC ID 4981751617, 251 clinicians

Practice addresses (Care Compare)

1732 W N St
Kendallville, IN 46755-2850
Phone (931) 253-1110

800 Broadway
Suite 100
Fort Wayne, IN 46802-2149
Phone (260) 425-2630

Hospital & facility affiliations

  • Dupont Hospital LLC Hospital, Fort Wayne, IN, CCN 150150

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Lutheran Medical Group LLC CurrentSince Sep 1, 2025 Accepting new patients
Fast Pace Medical Clinic PLLC CurrentSince Feb 13, 2024 Accepting new patients
Fast Pace Medical Clinic PLLC CurrentSince Feb 13, 2024 Accepting new patients
Lutheran Medical Group LLC Nurse Practitioner CurrentSince Sep 1, 2025 Accepting new patients

Locations

7980 W Jefferson Blvd
Fort Wayne, IN 46804
Phone (260) 459-1587

2516 E DuPont Rd
Fort Wayne, IN 46825
Phone (260) 434-6076

800 Broadway
Ste 100
Fort Wayne, IN 46802
Phone (260) 425-2630

4152 W State Road 56
Hanover, IN 47243
Phone (812) 762-4510

1732 W North St
Kendallville, IN 46755
Phone (260) 544-8054

Organizations & group practices 4

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 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": "1656979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757894400000",
    "number": "1013640200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 BROADWAY STE 100",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468022149",
            "telephone_number": "260-425-2630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 BROADWAY STE 100",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468022149",
            "telephone_number": "260-425-2630",
            "fax_number": "260-425-2631"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MYSLIWIEC",
        "first_name": "ELIZABETH",
        "middle_name": "ANNE",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-05",
        "last_updated": "2025-09-15",
        "certification_date": "2025-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "28153761A",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IN",
            "license": "71014932A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "elizabeth.mysliwiec@lutheranhealthnetwork.cernerdirect.com",
            "affiliation": "N",
            "endpointDescription": "DM",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "800 Broadway Ste 100",
            "city": "Fort Wayne",
            "state": "IN",
            "country_code": "US",
            "postal_code": "468022149",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

Verify at the official NPI Registry.