Individual provider Active NPI

Danielle Dorine Gontarz, FNP, RN

  • Family Medicine Physician
  • Brownsburg, IN
National Provider Identifier
1720624158
Registry record updated Jul 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
95012874 Issued in CA
Practice address
90 E Garner Rd
Brownsburg, IN 46112-9359
Phone
(317) 858-7566
Fax
(317) 858-7568
NPI assigned
Nov 20, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 71012022A IN
Family Medicine Physician 207Q00000X 95012874 CA Primary

Addresses

Primary practice location

90 E Garner Rd
Brownsburg, IN 46112-9359

Mailing address

250 N Shadeland Ave
Indianapolis, IN 46219-4959

Other practice location 1

1419 Madeira Dr
Pacifica, CA 94044-4332
Phone (765) 748-6523

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address dgontarz@direct.iuhealth.org Direct

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
I20220728001636 IN Practitioner - Nurse Practitioner 8224468004 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

90 E Garner Rd
Iu Health Urgent Care LLC
Brownsburg, IN 46112-9359
Phone (225) 214-1031

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
95012874CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Indiana University Health Urgent Care Centers, LLC CurrentSince Sep 1, 2022 Accepting new patients
Indiana University Health Urgent Care Centers, LLC. CurrentSince Sep 1, 2022 Accepting new patients

Locations

90 E Garner Rd
Brownsburg, IN 46112
Phone (225) 214-1031

250 N Shadeland Ave
Indianapolis, IN 46219
Phone (317) 948-9174

Interoperability endpoints

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

Organizations & group practices 2

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": "1574208000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658707200000",
    "number": "1720624158",
    "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": "90 E GARNER RD",
            "city": "BROWNSBURG",
            "state": "IN",
            "postal_code": "461129359",
            "telephone_number": "317-858-7566",
            "fax_number": "317-858-7568"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1419 Madeira Dr",
            "address_purpose": "LOCATION",
            "city": "Pacifica",
            "state": "CA",
            "postal_code": "940444332",
            "country_code": "US",
            "telephone_number": "765-748-6523",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GONTARZ",
        "first_name": "DANIELLE",
        "middle_name": "DORINE",
        "credential": "FNP, RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-20",
        "last_updated": "2022-07-25",
        "certification_date": "2022-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71012022A",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "95012874",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dgontarz@direct.iuhealth.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "90 E Garner Rd",
            "city": "Brownsburg",
            "state": "IN",
            "country_code": "US",
            "postal_code": "461129359",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Brownsburg, IN

Sources for this page

Verify at the official NPI Registry.