Individual provider Active NPI

Anne-Marie Nicole Fleckenstein, PHD

  • Psychologist
  • Indianapolis, IN
National Provider Identifier
1386366391
Registry record updated Mar 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
20043612A Issued in IN
Practice address
355 W 16TH St Ste 2500
Indianapolis, IN 46202-2280
Phone
(317) 963-7204
Fax
(317) 963-7211
NPI assigned
Sep 15, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X 20043612A IN
Health Service Psychologist 103TH0100X 20043612B IN
Psychologist 103T00000X 20043612A IN Primary

Addresses

Primary practice location

355 W 16TH St Ste 2500
Indianapolis, IN 46202-2280

Mailing address

250 N Shadeland Ave
Indianapolis, IN 46219-4959

Other practice location 1

1701 N Senate Blvd
Indianapolis, IN 46202-1239
Phone (888) 484-3258

Other identifiers 2

IdentifierTypeStateIssuer
300069161MedicaidIN
1102717688OtherINANTHEM PTAN

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address amfleckenstein@direct.iuhealth.org Direct
Direct Messaging Address amfleckenstein@direct.iuhealth.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221024000351 IN Practitioner - Psychologist Billing Independently 2668848243 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
20043612AINMDClinical Neuropsychologist
20043612BINMDHealth Service Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Iu Health Medical Group, LLC CurrentSince Apr 1, 2025 Accepting new patients
Iu Health Medical Group Riley Specialists, LLC Psychologist CurrentSince Jan 1, 2026 Accepting new patients
Indiana Clinic-Neurology, LLC CurrentSince Dec 1, 2022 Accepting new patients

Locations

3879 Reliable Pkwy
Chicago, IL 60686

350 S Landmark Ave
Bloomington, IN 47403
Phone (812) 332-9874

355 W 16th St
Ste 2500
Indianapolis, IN 46202
Phone (317) 963-7204

250 N Shadeland Ave
Indianapolis, IN 46219
Phone (317) 948-9174

705 Riley Hospital Dr
Indianapolis, IN 46202
Phone (317) 274-4779

355 W 16th St
Indianapolis, IN 46202
Phone (317) 963-7070

1701 Senate Blvd
Indianapolis, IN 46202
Phone (317) 612-2754

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1663200000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741305600000",
    "number": "1386366391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 N SHADELAND AVE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462194959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "355 W 16TH ST STE 2500",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462022280",
            "telephone_number": "317-963-7204",
            "fax_number": "317-963-7211"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1701 N Senate Blvd",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462021239",
            "country_code": "US",
            "telephone_number": "888-484-3258",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FLECKENSTEIN",
        "first_name": "ANNE-MARIE",
        "middle_name": "NICOLE",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-15",
        "last_updated": "2025-03-07",
        "certification_date": "2025-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "IN",
            "license": "20043612A",
            "primary": false
        },
        {
            "code": "103TH0100X",
            "taxonomy_group": "",
            "desc": "Psychologist, Health Service",
            "state": "IN",
            "license": "20043612B",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "IN",
            "license": "20043612A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300069161",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM PTAN",
            "identifier": "1102717688",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "amfleckenstein@direct.iuhealth.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "355 W 16th St Ste 2500",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "462022280",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "amfleckenstein@direct.iuhealth.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1701 N Senate Blvd",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "462021239",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.