Katelyn Marie Dickelman, AGNP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

71014176A Issued in IN

Practice address

503 E Summit St
Crown Point, IN 46307-3377

Phone

(219) 228-4224

NPI assigned

Aug 30, 2022

Last updated

Sep 20, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Monarch Health and WellnessGroup PAC ID 6406222942, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Monarch Health & Wellness

  • Primary Care Clinic/Center
  • Crown Point, IN
  • NPI 1205570025
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1661817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695168000000",
    "number": "1356061436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "503 E SUMMIT ST",
            "city": "CROWN POINT",
            "state": "IN",
            "postal_code": "463073377",
            "telephone_number": "219-228-4224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "503 E SUMMIT ST",
            "city": "CROWN POINT",
            "state": "IN",
            "postal_code": "463073377",
            "telephone_number": "219-228-4224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DICKELMAN",
        "first_name": "KATELYN",
        "middle_name": "MARIE",
        "credential": "AGNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-30",
        "last_updated": "2023-09-20",
        "certification_date": "2023-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WX0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Oncology",
            "state": "IL",
            "license": "041455840",
            "primary": false
        },
        {
            "code": "163WX0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Oncology",
            "state": "IN",
            "license": "28276637A",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "IN",
            "license": "71014176A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Megan Dexter, FNP
• Margaret Ann Deyoung, RN, MS, CNS
• Teri Deyoung, OTR, ECHM
• Angelina Diaz, RBT
• Arianna Marie Diaz, LSW, MSW
• Leah Diekow
• Nicholas Mitchell Dimarco
• Kelsi Dimitt
• Divine Wound Specialist L.L.C
• DK Orthopedics LLC

• Adult Health Nurse Practitioner in Crown Point, IN
• Providers in Crown Point, IN by specialty
• Adult Health Nurse Practitioner in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.