Ibitayo K Arise
Individual provider Active NPI Psychiatric/Mental Health Nurse Practitioner · Indianapolis, IN
NPI 1104699263 · NPPES record last updated Nov 1, 2023
Key facts
- NPI
- 1104699263
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner 363LP0808X
- License
- 71014315A (IN)
- Practice address
- 3850 Shore Dr Ste 315
Indianapolis, IN 46254-4693 - Phone
- (317) 429-0061
- NPI assigned
- Nov 1, 2023
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2023
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Exceptional Care Services LLC
Practice addresses (Care Compare)
3895 S Keystone Ave
The Waters of Indianapolis
Indianapolis, IN 46227-3540
Phone (317) 787-5364
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250214001024 | IN | Practitioner - Nurse Practitioner | 9436689817 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 71014315A | IN | MD | Psychiatric/Mental Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hospital Care Group, P.C. | Current |
Accepting new patients | |
| Exceptional Care Services LLC | Current |
Accepting new patients |
Locations
3955 W Washington Center Rd
Fort Wayne, IN 46818
Phone (260) 800-3601
2520 E DuPont Rd
Fort Wayne, IN 46825
Phone (219) 407-8000
6435 W Jefferson Blvd
Fort Wayne, IN 46804
Phone (260) 436-7875
950 N Lakeview Dr
Greensburg, IN 47240
Phone (812) 662-7778
3895 S Keystone Ave
Indianapolis, IN 46227
Phone (317) 787-5364
1050 Chinoe Rd
Ste 350
Lexington, KY 40502
Phone (606) 275-9869
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 71014315A | IN | Yes |
Addresses
Primary practice location
3850 Shore Dr Ste 315
Indianapolis, IN 46254-4693
Mailing address
8471 Ballyshannon Dr
Brownsburg, IN 46112-7320
Phone (317) 985-5899
Other providers in Indianapolis, IN
- Grace Nicole Arididon
- Maaz Arif
- Deniz Arikan
- Arise Wellness Clinic
- Arise Wellness Clinic
- Andrea Aristizabal
- Craig Anthony Arive
- Marta Arjonilla
- Ark Family Care LLC
- Ark Health and Social Services
All providers in Indianapolis, IN · Psychiatric/Mental Health Nurse Practitioner in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 1, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.