Individual provider Active NPI

Diane Trkulja-Castro, NURSE PRACTITIONER

  • Primary Care Nurse Practitioner
  • Chesterton, IN
National Provider Identifier
1689109084
Registry record updated Jan 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
71007089A Issued in IN
Practice address
3100 Village PT Ste 250
Chesterton, IN 46304-9695
Phone
(219) 440-4835
Fax
(855) 238-6150
NPI assigned
Apr 24, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2025

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 28187141A IN
Family Nurse Practitioner 363LF0000X 71007089A IN
Primary Care Nurse Practitioner 363LP2300X 71007089A IN Primary

Addresses

Primary practice location

3100 Village PT Ste 250
Chesterton, IN 46304-9695

Mailing address

3100 Village PT Ste 250
Chesterton, IN 46304-9695
Phone (219) 440-4835

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
I20211208001886 IN Practitioner - Nurse Practitioner 5092105973 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
28187141AINMDRegistered Nurse
71007089AINMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Villagemd Indiana, PC CurrentSince Nov 1, 2021 Accepting new patients

Locations

125 S Clark St
Ste 900
Chicago, IL 60603
Phone (346) 980-2701

6097 Broadway
Merrillville, IN 46410
Phone (219) 758-5152

5995 US Highway 6
Portage, IN 46368
Phone (219) 762-2134

Organizations & group practices 1

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": "1492992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736208000000",
    "number": "1689109084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3100 VILLAGE PT STE 250",
            "city": "CHESTERTON",
            "state": "IN",
            "postal_code": "463049695",
            "telephone_number": "219-440-4835",
            "fax_number": "855-238-6150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 VILLAGE PT STE 250",
            "city": "CHESTERTON",
            "state": "IN",
            "postal_code": "463049695",
            "telephone_number": "219-440-4835",
            "fax_number": "855-238-6150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRKULJA-CASTRO",
        "first_name": "DIANE",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-24",
        "last_updated": "2025-01-07",
        "certification_date": "2025-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IN",
            "license": "28187141A",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71007089A",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "IN",
            "license": "71007089A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chesterton, IN

Sources for this page

Verify at the official NPI Registry.