Individual provider Active NPI

Caitlin Krouse

  • Family Nurse Practitioner
  • Fort Wayne, IN
National Provider Identifier
1184986259
Registry record updated Jul 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
28186015A Issued in IN
Practice address
1720 Beacon St
Fort Wayne, IN 46805-4749
Phone
(260) 373-8000
Fax
(260) 373-8034
NPI assigned
Jun 13, 2012
Last updated
Jul 15, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 28186015A IN Primary

Addresses

Primary practice location

1720 Beacon St
Fort Wayne, IN 46805-4749

Mailing address

1700 N Illinois St
Indianapolis, IN 46202-1316

Other practice location 1

1700 N Illinois St
Indianapolis, IN 46202-1316
Phone (317) 571-5741

Other practice location 2

909 E State Blvd
Fort Wayne, IN 46805-3404
Phone (260) 481-2700

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
I20120727000379 IN Practitioner - Nurse Practitioner 6507022076 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Park Center IncGroup PAC ID 5991794794, 47 clinicians

Practice addresses (Care Compare)

909 E State Blvd
Fort Wayne, IN 46805-3458
Phone (260) 481-2718

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
91.37 of 100Reported as group
Quality
80.38
Promoting interoperability
100
Improvement activities
40
Cost
74.18

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
28186015AINMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Park Center Inc CurrentSince Jun 17, 2024 Accepting new patients
Park Center Inc CurrentSince Jun 17, 2024 Accepting new patients
Parkview Health System Inc Family Current Accepting new patients
Parkview Health System, Inc. CurrentSince Jun 17, 2024 Accepting new patients

Locations

11109 Parkview Plaza Dr
#117
Fort Wayne, IN 46845
Phone (260) 266-6012

1720 Beacon St
Fort Wayne, IN 46805
Phone (260) 373-7500

909 E State Blvd
Fort Wayne, IN 46805
Phone (260) 481-2718

512 Professional Way
Kendallville, IN 46755
Phone (260) 347-8556

Interoperability endpoints

  • Direct secure messaging: ckrouse95085@direct.parkviewexchange.com

Organizations & group practices 4

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 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": "1339545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721001600000",
    "number": "1184986259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 N ILLINOIS ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462021316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1720 BEACON ST",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468054749",
            "telephone_number": "260-373-8000",
            "fax_number": "260-373-8034"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1700 N Illinois St",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462021316",
            "country_code": "US",
            "telephone_number": "317-571-5741",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "909 E State Blvd",
            "address_purpose": "LOCATION",
            "city": "Fort Wayne",
            "state": "IN",
            "postal_code": "468053404",
            "country_code": "US",
            "telephone_number": "260-481-2700",
            "fax_number": "260-481-2838",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KROUSE",
        "first_name": "CAITLIN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-13",
        "last_updated": "2024-07-15",
        "certification_date": "2024-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "28186015A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

Verify at the official NPI Registry.