Kaitlin Etzcorn, NP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

71011071A Issued in IN

Practice address

5050 N Clinton St
Fort Wayne, IN 46825-5886

Phone

(260) 484-8551

NPI assigned

Nov 20, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Kaitlin Boester Former name

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, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Orthopaedics Northeast PCGroup PAC ID 9234024878, 80 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Parkview Regional Medical Center Hospital, Fort Wayne, IN, CCN 150021
• Parkview Whitley Hospital Hospital, Columbia City, IN, CCN 150101
• Parkview Huntington Hospital Hospital, Huntington, IN, CCN 150091
• Parkview Noble Hospital Hospital, Kendallville, IN, CCN 150146
• Orthopaedic Hospital at Parkview North Hospital, Fort Wayne, IN, CCN 150167

Merit-based Incentive Payment System (MIPS)

Final score

87.82 of 100Reported as group

Quality

85.67

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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.

• Orthopaedics Northeast PC

  • Orthopaedic Surgery Physician
  • Fort Wayne, IN
  • NPI 1740268796
  Medicare reassignment Care Compare group NPD
• Orthopaedics Northeast PC

  • Ambulatory Surgical Clinic/Center
  • Fort Wayne, IN
  • NPI 1417936477
  NPD

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

• Community Hospital of Noble County, Inc.

  • General Acute Care Hospital
  • Kendallville, IN
  • NPI 1457366189
  Care Compare affiliation
• Huntington Memorial Hospital, Inc.

  • General Acute Care Hospital
  • Huntington, IN
  • NPI 1003821729
  Care Compare affiliation
• Orthopaedic Hospital at Parkview North, LLC

  • Special Hospital
  • Fort Wayne, IN
  • NPI 1568664613
  Care Compare affiliation
• Parkview Hospital, Inc.

  • General Acute Care Hospital
  • Fort Wayne, IN
  • NPI 1366407603
  Care Compare affiliation
• Whitley Memorial Hospital, Inc.

  • General Acute Care Hospital
  • Columbia City, IN
  • NPI 1205844495
  Care Compare affiliation
• Whitley Memorial Hospital, Inc.

  • Land Ambulance
  • Columbia City, IN
  • NPI 1497764450

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1605830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628812800000",
    "number": "1972106847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10227 GREENMOOR DR",
            "city": "NEW HAVEN",
            "state": "IN",
            "postal_code": "467742287",
            "telephone_number": "260-602-7795"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5050 N CLINTON ST",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468255886",
            "telephone_number": "260-484-8551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ETZCORN",
        "first_name": "KAITLIN",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-20",
        "last_updated": "2021-08-13",
        "certification_date": "2021-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WX0800X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Orthopedic",
            "state": "IN",
            "license": "28197283A",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71011071A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KAITLIN",
            "last_name": "BOESTER",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Eduardo Estrada Martinez
• Jenniffer Gaite Etchison, PT
• Joelyn M Etgen, NP-C
• Faith Elizabeth Etherington, PA
• Sheryl J Etnier-Colon, NP
• Dawn Lesley Etzel
• Kam Ellen Etzler, RPH
• Ashley Susan Eubank
• Brandon James Euen, PHARMD
• Justin Eutsler, COTA

• Family Nurse Practitioner in Fort Wayne, IN
• Providers in Fort Wayne, 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 Aug 13, 2021; 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.