Individual provider Active NPI

Mary Frances Lotz, PA-C

  • Medical Physician Assistant
  • Indianapolis, IN
National Provider Identifier
1134577596
Registry record updated Jun 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
10002033A Issued in IN
Practice address
2001 W 86TH St
Indianapolis, IN 46260-1902
Phone
(317) 338-2345
NPI assigned
May 26, 2016
Last updated
Jun 6, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 10002033A IN
Medical Physician Assistant 363AM0700X 10002033A IN Primary

Addresses

Primary practice location

2001 W 86TH St
Indianapolis, IN 46260-1902

Mailing address

8840 Commerce Park PL Ste E
Indianapolis, IN 46268-3129

Other practice location 1

5177 McCarty Ln
Lafayette, IN 47905-8764
Phone (765) 448-8000

Other names 1

  • Mary Frances Broadhurst Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mlotz@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
I20160629000320 IN Practitioner - Physician Assistant 5991096539 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Vincent Medical Group IncGroup PAC ID 7012047640, 728 clinicians

Practice addresses (Care Compare)

2001 W 86TH St
Indianapolis, IN 46260-1902
Phone (317) 338-2345

8433 Harcourt Rd
Suite 100
Indianapolis, IN 46260-2193
Phone (317) 583-7600

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Arnett Clinic, LLC CurrentSince Jul 15, 2023 Accepting new patients
St. Vincent Medical Group, Inc. CurrentSince Aug 1, 2016 Accepting new patients
Arnett Clinic, LLC CurrentSince Jul 15, 2023 Accepting new patients
St. Vincent Medical Group, Inc. CurrentSince Aug 1, 2016 Accepting new patients
St Vincent Medical Group Inc Past Accepting new patients

Locations

8016 Reliable Pkwy
Chicago, IL 60686

11455 N Meridian St
Ste 200
Carmel, IN 46032
Phone (317) 582-8180

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

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

8433 Harcourt Rd
Ste 100
Indianapolis, IN 46260
Phone (317) 583-7702

8840 Commerce Park Pl
Ste E
Indianapolis, IN 46268
Phone (317) 583-4420

2600 Greenbush St
Lafayette, IN 47904

5165 McCarty Ln
Lafayette, IN 47905
Phone (800) 899-8448

5177 McCarty Ln
Lafayette, IN 47905
Phone (765) 838-7101

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1464220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686009600000",
    "number": "1134577596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8840 COMMERCE PARK PL STE E",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462683129"
        },
        {
            "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": "5177 McCarty Ln",
            "address_purpose": "LOCATION",
            "city": "Lafayette",
            "state": "IN",
            "postal_code": "479058764",
            "country_code": "US",
            "telephone_number": "765-448-8000",
            "fax_number": "765-838-8000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LOTZ",
        "first_name": "MARY",
        "middle_name": "FRANCES",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-26",
        "last_updated": "2023-06-06",
        "certification_date": "2023-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IN",
            "license": "10002033A",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "IN",
            "license": "10002033A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mlotz@direct.iuhealth.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "5177 McCarty Ln",
            "city": "Lafayette",
            "state": "IN",
            "country_code": "US",
            "postal_code": "479058764",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "BROADHURST",
            "middle_name": "FRANCES",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.