Individual provider Active NPI

Stacy A Lobodzinski, NP

  • Family Nurse Practitioner
  • Indianapolis, IN
National Provider Identifier
1174713820
Registry record updated Feb 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
71001400A Issued in IN
Practice address
1701 N Senate Blvd
ER B412
Indianapolis, IN 46202-1239
Phone
(317) 962-8880
Fax
(317) 962-7086
NPI assigned
Jul 30, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 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 71001400 IN
Family Nurse Practitioner 363LF0000X 71001400A IN Primary

Addresses

Primary practice location

1701 N Senate Blvd
ER B412
Indianapolis, IN 46202-1239

Mailing address

250 N Shadeland Ave
Indianapolis, IN 46219-4959

Other identifiers 6

IdentifierTypeStateIssuer
000001414272OtherINANTHEM PTAN
000000668467OtherINANTHEM PTAN
000001067786OtherINANTHEM PTAN
000001258280OtherINANTHEM PTAN
000001314774OtherINANTHEM PTAN
200880160MedicaidIN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address slobodzi@direct.iuhealth.org

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
I20080605000043 IN Practitioner - Nurse Practitioner 7911077763 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Iu Health Medical Group LLCGroup PAC ID 9638617913, 4,382 clinicians

Practice addresses (Care Compare)

1701 N Senate Blvd
Indianapolis, IN 46202-1239
Phone (888) 484-3258

Hospital & facility affiliations

  • Indiana University Health Hospital, Indianapolis, IN, CCN 150056
  • Indiana University Health North Hospital Hospital, Carmel, IN, CCN 150161
  • Iu Health West Hospital Hospital, Avon, IN, CCN 150158

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
71001400INMDFamily Nurse Practitioner
71001400AINMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Indiana Clinic Critical Care LLC CurrentSince May 1, 2019 Accepting new patients
Indiana University Health Care Associates, Inc Family CurrentSince Mar 21, 2010 Accepting new patients
Iu Health Medical Group, LLC Family CurrentSince Apr 1, 2025 Accepting new patients
Emergency Medical Group, Inc. Past Accepting new patients
Icem, LLC Past Accepting new patients
University Medical Diagnostic Associates, Inc. Past Accepting new patients

Locations

5208 Reliable Pkwy
Chicago, IL 60686

2574 Reliable Pkwy
Chicago, IL 60686

1111 Ronald Reagan Pkwy
Avon, IN 46123
Phone (317) 217-3000

1115 Ronald Reagan Pkwy
Ste 171
Avon, IN 46123
Phone (317) 217-2888

1701 N Senate Blvd
Bldg C6
Indianapolis, IN 46202
Phone (913) 962-2000

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

1801 Senate Blvd
Ste 230
Indianapolis, IN 46202
Phone (317) 962-5280

250 N Shadeland Ave
Fl 2
Indianapolis, IN 46219

1701 Senate Blvd
Indianapolis, IN 46202
Phone (317) 612-2754

1801 Senate Blvd
Indianapolis, IN 46202
Phone (317) 929-8880

Interoperability endpoints

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

Organizations & group practices 6

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 3

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": "1185753600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739404800000",
    "number": "1174713820",
    "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": "1701 N SENATE BLVD",
            "address_2": "ER B412",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462021239",
            "telephone_number": "317-962-8880",
            "fax_number": "317-962-7086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOBODZINSKI",
        "first_name": "STACY",
        "middle_name": "A",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-30",
        "last_updated": "2025-02-13",
        "certification_date": "2025-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71001400",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71001400A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM PTAN",
            "identifier": "000001414272",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM PTAN",
            "identifier": "000000668467",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM PTAN",
            "identifier": "000001067786",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM PTAN",
            "identifier": "000001258280",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM PTAN",
            "identifier": "000001314774",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200880160",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "slobodzi@direct.iuhealth.org",
            "affiliation": "N",
            "address_1": "1701 N Senate Blvd",
            "address_2": "ER B412",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "462021239",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.