Eric Thomas Degraaf, NP
Individual provider Active NPI Family Nurse Practitioner · Mooresville, IN
NPI 1316614605 · NPPES record last updated Sep 15, 2021
Key facts
- NPI
- 1316614605
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 71011387A (IN)
- Practice address
- 820 N Samuel Moore Pkwy Ste C
Mooresville, IN 46158-1467 - Phone
- (317) 483-5080
- NPI assigned
- Aug 25, 2021
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 5
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210914001799 | IN | Practitioner - Nurse Practitioner | 1153727342 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 71011387A | IN | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University Family Physicians, Inc. | Current |
Accepting new patients | |
| University Family Physicians, Inc. | Current |
Accepting new patients | |
| Iu Health Medical Group, LLC | Family | Current |
Accepting new patients |
| Indiana University Health Care Associates, Inc | Family | Current |
Accepting new patients |
| University Medical Diagnostic Associates, Inc. | Past | Accepting new patients |
Locations
7216 Solutions Ctr
Chicago, IL 60677
5208 Reliable Pkwy
Chicago, IL 60686
1520 N Senate Ave
Indianapolis, IN 46202
Phone (317) 962-0857
250 N Shadeland Ave
Indianapolis, IN 46219
Phone (317) 948-9174
1701 Senate Blvd
Indianapolis, IN 46202
Phone (317) 612-2754
1701 N Senate Blvd
Bldg C6
Indianapolis, IN 46202
Phone (913) 962-2000
820 N Samuel Moore Pkwy
Mooresville, IN 46158
Phone (317) 483-5000
820 N Samuel Moore Pkwy
Ste C
Mooresville, IN 46158
Phone (317) 483-5080
820 N Samuel Moore Pkwy
Ste A
Mooresville, IN 46158
Phone (317) 483-5000
302 N Dan Jones Rd
Ste 161
Plainfield, IN 46168
Phone (317) 754-5080
Interoperability endpoints
- edegraaf@direct.iuhealth.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 71011387A | IN | Yes |
Addresses
Primary practice location
820 N Samuel Moore Pkwy Ste C
Mooresville, IN 46158-1467
Mailing address
250 N Shadeland Ave
Indianapolis, IN 46219-4959
Other practice location 1
Riley Pediatrics Mooresville
820 Samuel Moore Pkwy, Suite C
Mooresville, IN 46158
Phone (317) 483-5080
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | edegraaf@direct.iuhealth.org |
Other providers in Mooresville, IN
- Kay Lyn Couse
- Dailey Chiropractic
- Ryan Dailey
- Brenda Jeanne Danner
- Conner Adrian Davis
- Joyce Delp
- Tina Delph
- Samantha Demoss
- Kelsey S Demott
- Dennis W Knierim DDS PC
All providers in Mooresville, IN · Family Nurse Practitioner in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 15, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.