NPIMap

Individual provider Active NPI

Elizabeth Renee Wittenmyer, PA-C

  • Physician Assistant
  • Indianapolis, IN
National Provider Identifier
1780765016
Registry record updated Oct 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
10000617A Issued in IN
Practice address
5330 E Stop 11 Rd
Indianapolis, IN 46237-6345
Phone
(317) 893-1900
Fax
(317) 893-1901
NPI assigned
Oct 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA200258 LA
Physician Assistant 363A00000X 10000617 IN
Physician Assistant 363A00000X 10000617A IN Primary

Addresses

Primary practice location

5330 E Stop 11 Rd
Indianapolis, IN 46237-6345

Mailing address

PO Box 781076
Detroit, MI 48278-1076
Phone (317) 528-4800

Other practice location 1

1402 E County Line Rd
Suite 2400
Indianapolis, IN 46227-0963
Phone (317) 887-7880

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ewittenmyer169967@Direct.FranciscanAlliance.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040925000035 IN Practitioner - Physician Assistant 3173597416 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Franciscan Physician NetworkGroup PAC ID 3072790682, 1,152 clinicians

Practice addresses (Care Compare)

150 W Washington St
Shelbyville, IN 46176-1236
Phone (317) 865-5904

1704 Lafayette Rd
Crawfordsville, IN 47933-1071

5330 E Stop 11 Rd
Indianapolis, IN 46237-6345
Phone (317) 893-1900

8111 S Emerson Ave
Indianapolis, IN 46237-8601

Hospital & facility affiliations

  • Franciscan Health Indianapolis Hospital, Indianapolis, IN, CCN 150162
  • Franciscan Health Mooresville Hospital, Mooresville, IN, CCN 150057
  • Decatur County Memorial Hospital Hospital, Greensburg, IN, CCN 151332
  • Major Hospital Hospital, Shelbyville, IN, CCN 150097
  • Columbus Regional Hospital Hospital, Columbus, IN, CCN 150112

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
10000617INMDPhysician Assistant
10000617AINMDPhysician Assistant
PA200258LAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
New Castle Clinic Inc CurrentSince Mar 1, 2021 Accepting new patients
Rush Memorial Hospital CurrentSince Jun 12, 2020 Accepting new patients
Rush Memorial Hospital Past Accepting new patients
Louisiana Emergency Physicians, LLC Past Accepting new patients
Lafountain Emergency Physicians LLC Past Accepting new patients
Creek Settlement Inpatient Services LLC Past Accepting new patients
Emergency Care Associates of Indiana, LLC Physician Assistant PastSince Sep 1, 2019 Accepting new patients
Major Hospital Past Accepting new patients

Locations

1000 N 16th St
Ste 240
New Castle, IN 47362
Phone (765) 521-1461

1300 N Main St
Rushville, IN 46173
Phone (317) 802-3106

110 E 13th St
Rushville, IN 46173
Phone (765) 932-7063

Interoperability endpoints

  • Direct secure messaging: ewittenmyer169967@direct.franciscanalliance.org

Organizations & group practices 11

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 6

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": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696204800000",
    "number": "1780765016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 781076",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482781076",
            "telephone_number": "317-528-4800",
            "fax_number": "317-865-1479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5330 E STOP 11 RD",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462376345",
            "telephone_number": "317-893-1900",
            "fax_number": "317-893-1901"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1402 E County Line Rd",
            "address_2": "Suite 2400",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462270963",
            "country_code": "US",
            "telephone_number": "317-887-7880",
            "fax_number": "317-887-7886",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WITTENMYER",
        "first_name": "ELIZABETH",
        "middle_name": "RENEE",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-17",
        "last_updated": "2023-10-02",
        "certification_date": "2023-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "LA",
            "license": "PA200258",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IN",
            "license": "10000617",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IN",
            "license": "10000617A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ewittenmyer169967@Direct.FranciscanAlliance.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "5330 E Stop 11 Rd",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "46237",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.