Individual provider Active NPI

Lateasa Tyler, NURSE PRACTITIONER

  • Adult Health Nurse Practitioner
  • Carmel, IN
National Provider Identifier
1366319469
Registry record updated Oct 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
28196273A Issued in IN
Practice address
118 Medical Dr
Carmel, IN 46032-3323
Phone
(317) 844-4211
NPI assigned
Oct 22, 2025
Last updated
Oct 22, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2025

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 28196273A IN Primary

Addresses

Primary practice location

118 Medical Dr
Carmel, IN 46032-3323

Mailing address

11313 USA Pkwy Ste E148
Fishers, IN 46037-9208
Phone (317) 781-4500

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
I20260126000087 IN Practitioner - Nurse Practitioner 4688180904 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lifespan Advanced Care LLCGroup PAC ID 7911484944, 15 clinicians

Practice addresses (Care Compare)

1667 Sheridan Rd
Noblesville, IN 46062-8723
Phone (317) 770-3434

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
28196273AINMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Will Power 2 LLC Current Accepting new patients
Lifespan Advanced Care LLC Adult Health CurrentSince Dec 17, 2025 Accepting new patients

Locations

118 Medical Dr
Carmel, IN 46032
Phone (317) 573-1037

11313 USA Pkwy
Ste E148
Fishers, IN 46037
Phone (314) 781-4500

3525 E Hanna Ave
#L
Indianapolis, IN 46237
Phone (317) 788-4261

1667 Sheridan Rd
Noblesville, IN 46062
Phone (317) 770-3400

Ownership & related parties

All facility ownership & control disclosures 5

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Harbour Manor Health & Living CommunityNoblesville, IN, CCN 155381 Skilled nursing facility Managing Control - Governing Body
Adp of the SNF
May 1, 2021
May 1, 2021
Arbor Trace Health & Living CommunityRichmond, IN, CCN 155481 Skilled nursing facility Adp of the SNF May 1, 2021
Altenheim Health & Living CommunityIndianapolis, IN, CCN 155196 Skilled nursing facility Managing Control - Governing Body
Adp of the SNF
May 1, 2021
May 1, 2021
Hamilton Trace of FishersFishers, IN, CCN 155793 Skilled nursing facility Adp of the SNF May 1, 2021
Copper Trace Health & Living CommunityWestfield, IN, CCN 155841 Skilled nursing facility Managing Control - Governing Body
Adp of the SNF
May 1, 2021
May 1, 2021

Owned or controlled facilities with NPI records 5

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1761091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761091200000",
    "number": "1366319469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11313 USA PKWY STE E148",
            "city": "FISHERS",
            "state": "IN",
            "postal_code": "460379208",
            "telephone_number": "317-781-4500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "118 MEDICAL DR",
            "city": "CARMEL",
            "state": "IN",
            "postal_code": "460323323",
            "telephone_number": "317-844-4211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TYLER",
        "first_name": "LATEASA",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-10-22",
        "last_updated": "2025-10-22",
        "certification_date": "2025-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "IN",
            "license": "28196273A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carmel, IN

Sources for this page

Verify at the official NPI Registry.