Individual provider Active NPI

Kristin L Tielker

  • Internal Medicine Physician
  • Carmel, IN
National Provider Identifier
1700809852
Registry record updated Oct 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
01059017A Issued in IN
Practice address
12107 Pebblepointe Pass
Carmel, IN 46033-9679
Phone
(999) 999-9999
NPI assigned
Jul 26, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 01059017A IN Primary

Addresses

Primary practice location

12107 Pebblepointe Pass
Carmel, IN 46033-9679

Mailing address

12107 Pebblepointe Pass
Carmel, IN 46033-9679
Phone (999) 999-9999

Other identifiers 1

IdentifierTypeStateIssuer
200530000MedicaidIN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ktielker7975@eCommunityDirect.com Community Physicians of Indiana Inc

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050804000726 IN Practitioner - Internal Medicine 4981633542 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Community Physicians of Indiana Inc Internal Medicine CurrentSince Mar 16, 2011 Accepting new patients
Community Physicians of Indiana Inc CurrentSince Mar 16, 2011 Accepting new patients
Major Hospital Past Accepting new patients

Locations

5819 Reliable Pkwy
Chicago, IL 60686

8101 Clearvista Pkwy
Ste 200
Indianapolis, IN 46256
Phone (317) 621-5390

7120 Clearvista Dr
Ste 4000
Indianapolis, IN 46256
Phone (317) 621-7444

6626 E 75th St
Ste 500
Indianapolis, IN 46250
Phone (317) 621-7547

19800 East St
#120
Westfield, IN 46074
Phone (317) 621-7120

Interoperability endpoints

  • Direct secure messaging: ktielker7975@ecommunitydirect.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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761177600000",
    "number": "1700809852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12107 PEBBLEPOINTE PASS",
            "city": "CARMEL",
            "state": "IN",
            "postal_code": "460339679",
            "telephone_number": "999-999-9999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12107 PEBBLEPOINTE PASS",
            "city": "CARMEL",
            "state": "IN",
            "postal_code": "460339679",
            "telephone_number": "999-999-9999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIELKER",
        "first_name": "KRISTIN",
        "middle_name": "L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-26",
        "last_updated": "2025-10-23",
        "certification_date": "2025-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IN",
            "license": "01059017A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200530000",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ktielker7975@eCommunityDirect.com",
            "affiliation": "Y",
            "affiliationName": "Community Physicians of Indiana Inc",
            "address_1": "8101 Clearvista Pkwy",
            "address_2": "Suite 200",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "462564675",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Carmel, IN

Sources for this page

Verify at the official NPI Registry.