Individual provider Active NPI

Victoria Love Lanzillotti, PA-C

  • Physician Assistant
  • Carmel, IN
National Provider Identifier
1295406817
Registry record updated Aug 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
10003842A Issued in IN
Practice address
10767 Illinois St Ste 3000
Carmel, IN 46032-8972
Phone
(317) 817-1200
Fax
(317) 817-1220
NPI assigned
Sep 23, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2023

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 10003842A IN Primary

Addresses

Primary practice location

10767 Illinois St Ste 3000
Carmel, IN 46032-8972

Mailing address

10767 Illinois St Ste 3000
Carmel, IN 46032-8972
Phone (317) 817-1200

Other names 1

  • Ms. Tori Love Lanzillotti Other name

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
I20230519001017 IN Practitioner - Physician Assistant 9234522863 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Mercy College, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

10767 Illinois St
Carmel, IN 46032-8972
Phone (317) 817-1200

1401 W County Line Rd
Methodist Sports Medicine
Greenwood, IN 46142-5195
Phone (317) 817-1200

16289 Boden Rd
Suite 2
Noblesville, IN 46060-9729
Phone (317) 817-1200

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
10003842AINMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Thomas a Brady Sports Medicine Center, PC Sports Medicine CurrentSince Jun 12, 2023 Accepting new patients
Thomas a Brady Sports Medicine Center, PC Sports Medicine CurrentSince Jun 12, 2023 Accepting new patients

Locations

10767 Illinois St
Ste 3000
Carmel, IN 46032
Phone (317) 708-6858

1401 W County Line Rd
Greenwood, IN 46142
Phone (317) 217-1200

16289 Boden Rd
Ste 2
Noblesville, IN 46060

1010 S Main St
Ste 100
Tipton, IN 46072

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": "1632355200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691625600000",
    "number": "1295406817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10767 ILLINOIS ST STE 3000",
            "city": "CARMEL",
            "state": "IN",
            "postal_code": "460328972",
            "telephone_number": "317-817-1200",
            "fax_number": "317-817-1220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10767 ILLINOIS ST STE 3000",
            "city": "CARMEL",
            "state": "IN",
            "postal_code": "460328972",
            "telephone_number": "317-817-1200",
            "fax_number": "317-817-1220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANZILLOTTI",
        "first_name": "VICTORIA",
        "middle_name": "LOVE",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-23",
        "last_updated": "2023-08-10",
        "certification_date": "2023-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IN",
            "license": "10003842A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TORI",
            "last_name": "LANZILLOTTI",
            "middle_name": "LOVE",
            "prefix": "MS.",
            "credential": "PA-C",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Carmel, IN

Sources for this page

Verify at the official NPI Registry.