Tyler P Kelly, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

71005109A Issued in IN

Practice address

120 Avon Market PL Ste 100
Avon, IN 46123-6021

Phone

(317) 396-1300

NPI assigned

Jul 11, 2014

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 4

Electronic endpoints 1

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

Specialty

Nurse Practitioner

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Indiana University Radiology Associates IncGroup PAC ID 7315922267, 213 clinicians

Iu Health Medical Group LLCGroup PAC ID 9638617913, 4,382 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Indiana University Health Hospital, Indianapolis, IN, CCN 150056

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• Indiana University Radiology Associates, Inc.

  • Diagnostic Radiology Physician
  • Indianapolis, IN
  • NPI 1336192665
  Medicare reassignment Care Compare group NPD
• Iu Health Medical Group, LLC

  • General Practice Physician
  • Indianapolis, IN
  • NPI 1326893777

  Family

  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Indiana University Health Inc

  • General Acute Care Hospital
  • Indianapolis, IN
  • NPI 1144266024
  Care Compare affiliation

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

{
    "created_epoch": "1405036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736208000000",
    "number": "1962818864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13345 ILLINOIS ST",
            "city": "CARMEL",
            "state": "IN",
            "postal_code": "460323318",
            "telephone_number": "317-396-1300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 AVON MARKET PL STE 100",
            "city": "AVON",
            "state": "IN",
            "postal_code": "461236021",
            "telephone_number": "317-396-1300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "555 E County Line Rd Ste 202",
            "address_purpose": "LOCATION",
            "city": "Greenwood",
            "state": "IN",
            "postal_code": "461431063",
            "country_code": "US",
            "telephone_number": "317-396-1300",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1701 N Senate Blvd",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462021239",
            "country_code": "US",
            "telephone_number": "317-962-6793",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KELLY",
        "first_name": "TYLER",
        "middle_name": "P",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-07-11",
        "last_updated": "2025-01-07",
        "certification_date": "2025-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71005109A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "APN PRESCRIPTIVE AUTHORITY",
            "identifier": "71005109A",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CSR PRESCRIPTIVE AUTHORITY",
            "identifier": "71005109B",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RN LICENSE",
            "identifier": "28189341A",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201252820",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tkelly@direct.iuhealth.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1701 N Senate Blvd",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "462021239",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Ravneet Kaur
• Paige K Kawiecki, PA-C
• James B Keating III, D.C.
• Tara E. Kegeris, FNP-C
• Christina Marie Kelley, NP
• Drew Alan Kelsey, DPT
• Robert A Kemp, MD
• Drew A Kepple, MD
• Grace Kershaw
• Nicole Amber Kestufskie, PA

• Family Nurse Practitioner in Avon, IN
• Providers in Avon, IN by specialty
• Family Nurse Practitioner in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.