Individual provider Active NPI

Lisa A Kleindorfer, ANP-BC

  • Adult Health Nurse Practitioner
  • Bedford, IN
National Provider Identifier
1205912995
Registry record updated Feb 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
71000179A Issued in IN
Practice address
2415 Mitchell Rd Ste C
Bedford, IN 47421-4747
Phone
(812) 279-6222
NPI assigned
Oct 27, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 71000179A IN Primary

Addresses

Primary practice location

2415 Mitchell Rd Ste C
Bedford, IN 47421-4747

Mailing address

8003 Castleway Dr
Indianapolis, IN 46250-1946
Phone (317) 576-1335

Other identifiers 1

IdentifierTypeStateIssuer
200224670AMedicaidIN

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
I20080520000055 IN Practitioner - Nurse Practitioner 1557430394 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
80.71 of 100Reported as group
Quality
56.86
Promoting interoperability
97
Improvement activities
40
Cost
81.33

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
71000179AINMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Eventus Ecs, Inc CurrentSince Jan 1, 2025 Accepting new patients
Monroe Medical Group Inc Adult Health CurrentSince Sep 11, 2023 Accepting new patients
St Vincent Medical Group Inc PastSince Jul 1, 2022 Accepting new patients

Locations

3209 W Reddy Way
Ste C
Bloomington, IN 47403
Phone (812) 825-6006

421 S Landmark Ave
Bloomington, IN 47403
Phone (812) 332-4468

150 W Market St
Ste 400
Indianapolis, IN 46204

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/8479/brand/1/csg/1/fhir/r4

Organizations & group practices 3

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1161907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675814400000",
    "number": "1205912995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8003 CASTLEWAY DR",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462501946",
            "telephone_number": "317-576-1335",
            "fax_number": "317-343-6562"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2415 MITCHELL RD STE C",
            "city": "BEDFORD",
            "state": "IN",
            "postal_code": "474214747",
            "telephone_number": "812-279-6222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLEINDORFER",
        "first_name": "LISA",
        "middle_name": "A",
        "credential": "ANP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-27",
        "last_updated": "2023-02-08",
        "certification_date": "2023-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "IN",
            "license": "71000179A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200224670A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bedford, IN

Sources for this page

Verify at the official NPI Registry.