Individual provider Active NPI

Stefani E Yudasz, CNP

  • Nurse Practitioner
  • Warsaw, IN
National Provider Identifier
1619360161
Registry record updated Jan 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
71007030A Issued in IN
Practice address
1275 Provident Dr
Warsaw, IN 46580-3265
Phone
(574) 269-4026
Fax
(574) 269-7444
NPI assigned
Mar 9, 2015
Last updated
Jan 25, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 71007030A IN Primary

Addresses

Primary practice location

1275 Provident Dr
Warsaw, IN 46580-3265

Mailing address

11109 Parkview Plaza Dr # 117
Fort Wayne, IN 46845-1701

Other practice location 1

11050 Parkview Circle Dr
Fort Wayne, IN 46845
Phone (833) 724-8326

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address stefani.yudasz@lutheranhealthnetwork.cernerdirect.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, IN2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20150330001413 OH Practitioner - Nurse Practitioner 6709103872 Reassigns benefits to 1 organization
I20170424000345 IN Practitioner - Nurse Practitioner 6709103872 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kosciusko Medical Group LLCGroup PAC ID 5496809956, 41 clinicians

Practice addresses (Care Compare)

2101 Dubois Dr
Warsaw, IN 46580-3210
Phone (574) 267-3200

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.99 of 100Reported as apm
Quality
77.41
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
71007030AINMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ohiohealth Corporation CurrentSince Mar 23, 2015 Accepting new patients
Ohiohealth Corporation CurrentSince Mar 23, 2015 Accepting new patients
Kosciusko Medical Group LLC CurrentSince Jan 1, 2023 Accepting new patients

Locations

6920 Pointe Inverness Way
Ste 200
Fort Wayne, IN 46804
Phone (260) 479-3514

1205 Provident Dr
#A
Warsaw, IN 46580
Phone (574) 269-8383

1275 Provident Dr
Warsaw, IN 46580
Phone (574) 269-4026

2101 Dubois Dr
Warsaw, IN 46580
Phone (219) 267-3200

393 E Town St
Ste 116
Columbus, OH 43215
Phone (614) 566-9108

500 Thomas Ln
Ste 2B
Columbus, OH 43214
Phone (614) 566-2280

5350 Frantz Rd
Dublin, OH 43016

Interoperability endpoints

  • Direct secure messaging: stefani.yudasz@lutheranhealthnetwork.cernerdirect.com

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1425859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674604800000",
    "number": "1619360161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11109 PARKVIEW PLAZA DR # 117",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468451701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1275 PROVIDENT DR",
            "city": "WARSAW",
            "state": "IN",
            "postal_code": "465803265",
            "telephone_number": "574-269-4026",
            "fax_number": "574-269-7444"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11050 Parkview Circle Dr",
            "address_purpose": "LOCATION",
            "city": "Fort Wayne",
            "state": "IN",
            "postal_code": "46845",
            "country_code": "US",
            "telephone_number": "833-724-8326",
            "fax_number": "260-425-6845",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YUDASZ",
        "first_name": "STEFANI",
        "middle_name": "E",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-09",
        "last_updated": "2023-01-25",
        "certification_date": "2023-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IN",
            "license": "71007030A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "stefani.yudasz@lutheranhealthnetwork.cernerdirect.com",
            "affiliation": "N",
            "endpointDescription": "AMR direct address",
            "address_1": "1275 Provident Dr",
            "city": "Warsaw",
            "state": "IN",
            "country_code": "US",
            "postal_code": "465803265",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Warsaw, IN

Sources for this page

Verify at the official NPI Registry.