Individual provider Active NPI

Karen Louise Klutzke, PA-C

  • Physician Assistant
  • Indianapolis, IN
National Provider Identifier
1487012134
Registry record updated Apr 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
10001919A Issued in IN
Practice address
714 N Senate Ave Ste 120
Indianapolis, IN 46202-3297
Phone
(317) 963-0555
NPI assigned
Feb 9, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 10001919A IN Primary
Medical Physician Assistant 363AM0700X 10001919A IN

Addresses

Primary practice location

714 N Senate Ave Ste 120
Indianapolis, IN 46202-3297

Mailing address

250 N Shadeland Ave
Indianapolis, IN 46219-4959

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kklutzke@direct.iuhealth.org

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
I20160419001109 IN Practitioner - Physician Assistant 6800194291 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Indiana Neuroscience Associates CurrentSince Mar 14, 2016 Accepting new patients
University Medical Diagnostic Associates, Inc. Past Accepting new patients
Major Hospital Past Accepting new patients

Locations

9302 N Meridian St
Ste 101
Indianapolis, IN 46260
Phone (317) 967-2220

6330 Castleplace Dr
Ste 130
Indianapolis, IN 46250

18051 River Rd
Ste 105
Noblesville, IN 46062
Phone (317) 779-3956

Interoperability endpoints

  • Direct secure messaging: kklutzke@direct.iuhealth.org

Organizations & group practices 5

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": "1454976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618272000000",
    "number": "1487012134",
    "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": "714 N SENATE AVE STE 120",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462023297",
            "telephone_number": "317-963-0555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLUTZKE",
        "first_name": "KAREN",
        "middle_name": "LOUISE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-02-09",
        "last_updated": "2021-04-13",
        "certification_date": "2021-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IN",
            "license": "10001919A",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "IN",
            "license": "10001919A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kklutzke@direct.iuhealth.org",
            "affiliation": "N",
            "address_1": "18051 River Rd",
            "address_2": "Suite 105",
            "city": "Noblesville",
            "state": "IN",
            "country_code": "US",
            "postal_code": "460627093",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.