Individual provider Active NPI

Kelly Elizabeth Dilts, PA-C

  • Physician Assistant
  • Indianapolis, IN
National Provider Identifier
1104518166
Registry record updated Nov 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
10004014A Issued in IN
Practice address
2001 W 86TH St
Indianapolis, IN 46260-1902
Phone
(317) 338-2345
NPI assigned
May 25, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X
Physician Assistant 363A00000X 10004014A IN Primary

Addresses

Primary practice location

2001 W 86TH St
Indianapolis, IN 46260-1902

Mailing address

14509 Bexley Dr
Carmel, IN 46033-8577
Phone (317) 590-3882

Other practice location 1

482 S Liberty Dr
Bloomington, IN 47403-1927
Phone (812) 353-3443

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kdilts@direct.iuhealth.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
I20230705000413 IN Practitioner - Physician Assistant 6709245061 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Indiana University Health Urgent Care Centers LLCGroup PAC ID 0042526063, 93 clinicians

Practice addresses (Care Compare)

1036 Broad Ripple Ave
Indianapolis, IN 46220-2035
Phone (317) 759-9960

222 W Michigan St
Iu Health Urgent Care LLC Downtow
Indianapolis, IN 46204-1254
Phone (225) 214-9352

90 E Garner Rd
Iu Health Urgent Care LLC
Brownsburg, IN 46112-9359
Phone (225) 214-1031

Hospital & facility affiliations

  • Indiana University Health Hospital, Indianapolis, IN, CCN 150056

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Indiana University Health Urgent Care Centers, LLC. CurrentSince Dec 1, 2024 Accepting new patients
Indiana University Health Urgent Care Centers, LLC CurrentSince Dec 1, 2024 Accepting new patients
Hendricks County Hospital CurrentSince Jun 12, 2023 Accepting new patients
Cep America LLC CurrentSince Jul 20, 2023 Accepting new patients
Hendricks County Hospital CurrentSince Jun 12, 2023 Accepting new patients
Cep America LLC CurrentSince Jul 20, 2023 Accepting new patients

Locations

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

8244 E US Highway 36
Ste 1100
Avon, IN 46123
Phone (317) 272-7500

482 S Liberty Dr
Bloomington, IN 47403
Phone (812) 353-3443

90 E Garner Rd
Brownsburg, IN 46112
Phone (225) 214-1031

250 N Shadeland Ave
Indianapolis, IN 46219
Phone (317) 948-9174

2001 W 86th St
Indianapolis, IN 46260
Phone (317) 338-3617

1606 N 7th St
Terre Haute, IN 47804
Phone (812) 238-7523

Interoperability endpoints

  • Direct secure messaging: kdilts@direct.iuhealth.org

Organizations & group practices 8

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": "1684972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732147200000",
    "number": "1104518166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14509 BEXLEY DR",
            "city": "CARMEL",
            "state": "IN",
            "postal_code": "460338577",
            "telephone_number": "317-590-3882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 W 86TH ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462601902",
            "telephone_number": "317-338-2345"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "482 S Liberty Dr",
            "address_purpose": "LOCATION",
            "city": "Bloomington",
            "state": "IN",
            "postal_code": "474031927",
            "country_code": "US",
            "telephone_number": "812-353-3443",
            "fax_number": "812-353-3442",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DILTS",
        "first_name": "KELLY",
        "middle_name": "ELIZABETH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-25",
        "last_updated": "2024-11-21",
        "certification_date": "2024-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IN",
            "license": "10004014A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kdilts@direct.iuhealth.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "482 S Liberty Dr",
            "city": "Bloomington",
            "state": "IN",
            "country_code": "US",
            "postal_code": "474031927",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.