Individual provider Active NPI

Kathleen Swilik, PA-S

  • Physician Assistant
  • Indianapolis, IN
National Provider Identifier
1215549753
Registry record updated Jul 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
10003563A Issued in IN
Practice address
3850 Shore Dr Ste 200
Indianapolis, IN 46254-5621
Phone
(317) 939-6100
NPI assigned
Aug 17, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 26, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 10003563A IN Primary

Addresses

Primary practice location

3850 Shore Dr Ste 200
Indianapolis, IN 46254-5621

Mailing address

1819 Carew St
Fort Wayne, IN 46805-4705

Other practice location 1

7301 N Shadeland Ave
Indianapolis, IN 46250-2085
Phone (317) 939-6100

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
I20220428001543 IN Practitioner - Physician Assistant 5193112738 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Indiana Neurology and Pain Center LLCGroup PAC ID 5294001574, 14 clinicians

Practice addresses (Care Compare)

3850 Shore Dr
Suite 203
Indianapolis, IN 46254-2610
Phone (317) 939-6100

Merit-based Incentive Payment System (MIPS)

Final score
58.34 of 100Reported as group
Quality
41.67
Promoting interoperability
0
Improvement activities
40
Cost
81.11

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
10003563AINMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Indiana Neurology and Pain Center LLC CurrentSince Apr 1, 2022 Accepting new patients
Theoria Medical Physician Assistant CurrentSince Sep 9, 2024 Accepting new patients

Locations

155 E Burks Dr
Bloomington, IN 47401
Phone (812) 322-4437

3850 Shore Dr
Ste 203
Indianapolis, IN 46254
Phone (317) 297-3774

7301 N Shadeland Ave
Ste 1A
Indianapolis, IN 46250
Phone (317) 577-1800

Interoperability endpoints

  • Direct secure messaging: kathleen.swilik@3126.securemail.prognocis.com

Organizations & group practices 2

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": "1597622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721952000000",
    "number": "1215549753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1819 CAREW ST",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468054705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3850 SHORE DR STE 200",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462545621",
            "telephone_number": "317-939-6100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7301 N Shadeland Ave",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462502085",
            "country_code": "US",
            "telephone_number": "317-939-6100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SWILIK",
        "first_name": "KATHLEEN",
        "credential": "PA-S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-08-17",
        "last_updated": "2024-07-26",
        "certification_date": "2024-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IN",
            "license": "10003563A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.