Kelley L Wormmeester, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

10002773A Issued in IN

Practice address

714 N Senate Ave Ste 100
Indianapolis, IN 46202-3297

Phone

(317) 715-6402

Fax

(317) 715-6415

NPI assigned

Sep 5, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

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

Specialty

Physician Assistant

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Iu Health Medical Group LLCGroup PAC ID 9638617913, 4,382 clinicians

Indiana University Radiology Associates IncGroup PAC ID 7315922267, 213 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Eskenazi Health Hospital, Indianapolis, IN, CCN 150024
• Indiana University Health Hospital, Indianapolis, IN, CCN 150056
• Indiana University Health Ball Memorial Hospital Hospital, Muncie, IN, CCN 150089

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kwormeester71923@direct.eskenazihealth.edu

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.

• Iu Health Medical Group, LLC

  • General Practice Physician
  • Indianapolis, IN
  • NPI 1326893777
  Medicare reassignment Care Compare group NPD
• Indiana University Radiology Associates, Inc.

  • Diagnostic Radiology Physician
  • Indianapolis, IN
  • NPI 1336192665
  Medicare reassignment Care Compare group

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Indiana University Health Ball Memorial Hospital, Inc.

  • General Acute Care Hospital
  • Muncie, IN
  • NPI 1225195340
  Care Compare affiliation
• Indiana University Health Inc

  • General Acute Care Hospital
  • Indianapolis, IN
  • NPI 1144266024
  Care Compare affiliation
• The Health and Hospital Corporation of Marion County

  • General Acute Care Hospital
  • Indianapolis, IN
  • NPI 1568407310
  Care Compare affiliation
• The Health and Hospital Corporation of Marion County

  • Methadone Clinic
  • Indianapolis, IN
  • NPI 1760922249

  Hospital

  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1567641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614124800000",
    "number": "1063061711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 N SHADELAND AVE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462194959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "714 N SENATE AVE STE 100",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462023297",
            "telephone_number": "317-715-6402",
            "fax_number": "317-715-6415"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WORMMEESTER",
        "first_name": "KELLEY",
        "middle_name": "L",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-05",
        "last_updated": "2021-02-24",
        "certification_date": "2021-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "IN",
            "license": "10002773A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kwormmeest@direct.iuhealth.org",
            "affiliation": "N",
            "address_1": "714 N Senate Ave Ste 100",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "462023297",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Nicholas Scott Worley, PA-C
• Seinneh Alice Worloma
• James Worman, PA-C
• Ripley W Worman, MD
• Molly Christine Wormley, MD
• Hanna Worpell, RBT
• Annaliesa Beth Worrell, NP, MSN-RN
• Katie Worrell
• Maxwell J Wors
• Sara Liang Worsham, DO

• Medical Physician Assistant in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Medical Physician Assistant in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.