Individual provider Active NPI

Mary Eileen Galetti, FNP-BC

  • Nurse Practitioner
  • Crown Point, IN
National Provider Identifier
1619586070
Registry record updated Mar 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
71010816A Issued in IN
Practice address
9330 Broadway
Crown Point, IN 46307-9830
Phone
(219) 648-2400
NPI assigned
Jul 30, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 28198927A IN
Registered Nurse 163W00000X 4704359018 MI
Nurse Practitioner 363L00000X 71010816A IN Primary

Addresses

Primary practice location

9330 Broadway
Crown Point, IN 46307-9830

Mailing address

9330 Broadway
Crown Point, IN 46307-9830
Phone (219) 648-2400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN, IL2 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
I20210302002716 IN Practitioner - Nurse Practitioner 8527474337 Reassigns benefits to 2 organizations
I20260121000904 IL Practitioner - Nurse Practitioner 8527474337 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MD @ Home Illinois, SCGroup PAC ID 7810167830, 53 clinicians
Aims LLCGroup PAC ID 6406126572, 8 clinicians

Practice addresses (Care Compare)

2003 W Fulton St
Suite 303
Chicago, IL 60612-2345
Phone (312) 243-2223

802 E 9TH St
Housecall Physicians of Illinois
Mishawaka, IN 46544-2314
Phone (312) 243-2223

9330 Broadway
Crown Point, IN 46307-9830
Phone (219) 648-2400

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
28198927AINMDRegistered Nurse
4704359018MIMDRegistered Nurse
71010816AINMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Aims-Med, LLC CurrentSince May 1, 2021 Accepting new patients
MD @ Home Illinois, SC CurrentSince Jan 12, 2026 Accepting new patients
Aims, LLC CurrentSince May 1, 2021 Accepting new patients

Locations

2003 W Fulton St
Ste 303
Chicago, IL 60612
Phone (312) 243-2223

417 S Whitlock St
Bremen, IN 46506
Phone (574) 546-0330

9330 Broadway
Crown Point, IN 46307
Phone (219) 648-2400

1167 Wilson Dr
Greenwood, IN 46143
Phone (317) 851-3101

6720 Parkdale Pl
Indianapolis, IN 46254
Phone (219) 648-2400

111 E 3rd St
Unit 764
Mishawaka, IN 46546

1625 E Jefferson Blvd
Mishawaka, IN 46545
Phone (219) 257-2295

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.

Hospital & facility affiliations 2

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": "1596067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647993600000",
    "number": "1619586070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9330 BROADWAY",
            "city": "CROWN POINT",
            "state": "IN",
            "postal_code": "463079830",
            "telephone_number": "219-648-2400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9330 BROADWAY",
            "city": "CROWN POINT",
            "state": "IN",
            "postal_code": "463079830",
            "telephone_number": "219-648-2400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GALETTI",
        "first_name": "MARY",
        "middle_name": "EILEEN",
        "name_prefix": "Mrs.",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-30",
        "last_updated": "2022-03-23",
        "certification_date": "2022-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IN",
            "license": "28198927A",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MI",
            "license": "4704359018",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IN",
            "license": "71010816A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crown Point, IN

Sources for this page

Verify at the official NPI Registry.