Individual provider Active NPI

Nicole Srutowski

  • Family Nurse Practitioner
  • Lafayette, IN
National Provider Identifier
1881205755
Registry record updated Aug 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
71010257A Issued in IN
Practice address
3750 Landmark Dr Ste B
Lafayette, IN 47905-6652
Phone
(765) 838-4100
NPI assigned
Aug 13, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 71010257A IN Primary

Addresses

Primary practice location

3750 Landmark Dr Ste B
Lafayette, IN 47905-6652

Mailing address

3750 Landmark Dr Ste B
Lafayette, IN 47905-6652

Other practice location 1

5165 McCarty Ln
Lafayette, IN 47905-8764
Phone (765) 448-8000

Other practice location 2

1701 S Creasy Ln
Lafayette, IN 47905-4972
Phone (765) 502-4000

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
I20200914000366 IN Practitioner - Nurse Practitioner 4981022613 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Iu Health Medical Group LLCGroup PAC ID 9638617913, 4,382 clinicians
Arnett Clinic LLCGroup PAC ID 0749184380, 401 clinicians

Practice addresses (Care Compare)

1701 N Senate Blvd
Indianapolis, IN 46202-1239
Phone (888) 484-3258

3750 Landmark Dr
Suite B
Lafayette, IN 47905-6652
Phone (765) 838-4100

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Arnett Clinic, LLC CurrentSince Oct 12, 2020 Accepting new patients
Arnett Clinic, LLC CurrentSince Oct 12, 2020 Accepting new patients
Arnett Clinic, LLC Current Accepting new patients
Iu Health Medical Group, LLC Family CurrentSince Jan 1, 2026 Accepting new patients

Locations

8016 Reliable Pkwy
Chicago, IL 60686

1701 Senate Blvd
Indianapolis, IN 46202
Phone (317) 612-2754

3750 Landmark Dr
Ste B
Lafayette, IN 47905
Phone (765) 448-7981

5165 McCarty Ln
Lafayette, IN 47905
Phone (800) 899-8448

1701 S Creasy Ln
Lafayette, IN 47905
Phone (765) 502-4400

2600 Greenbush St
Lafayette, IN 47904

1200 W White River Blvd
Muncie, IN 47303
Phone (765) 254-4009

Interoperability endpoints

  • Direct secure messaging: nsrutowski1@direct.iuhealth.org

Organizations & group practices 4

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": "1597276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597276800000",
    "number": "1881205755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3750 LANDMARK DR STE B",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479056652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3750 LANDMARK DR STE B",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479056652",
            "telephone_number": "765-838-4100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5165 McCarty Ln",
            "address_purpose": "LOCATION",
            "city": "Lafayette",
            "state": "IN",
            "postal_code": "479058764",
            "country_code": "US",
            "telephone_number": "765-448-8000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1701 S Creasy Ln",
            "address_purpose": "LOCATION",
            "city": "Lafayette",
            "state": "IN",
            "postal_code": "479054972",
            "country_code": "US",
            "telephone_number": "765-502-4000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SRUTOWSKI",
        "first_name": "NICOLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-13",
        "last_updated": "2020-08-13",
        "certification_date": "2020-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71010257A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lafayette, IN

Sources for this page

Verify at the official NPI Registry.