Individual provider Active NPI

Nicole Renee Zulkowski, M.D.

  • Physical Medicine & Rehabilitation Physician
  • Indianapolis, IN
National Provider Identifier
1982877569
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
01067400A Issued in IN
Practice address
7120 Clearvista Dr
Suite 1500
Indianapolis, IN 46256-1621
Phone
(317) 621-9292
Fax
(317) 621-9299
NPI assigned
Apr 3, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 01067400A IN Primary

Addresses

Primary practice location

7120 Clearvista Dr
Suite 1500
Indianapolis, IN 46256-1621

Mailing address

6626 E 75TH St
Suite 500
Indianapolis, IN 46250-2805

Other identifiers 2

IdentifierTypeStateIssuer
P01157064OtherINMEDICARE RR
201064020MedicaidIN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address nzulkowski51605@eCommunityDirect.com Community Physicians of Indiana Inc

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120727000597 IN Practitioner - Physical Medicine and Rehabilitation 6800052390 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
Indiana University School of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Physicians of Indiana IncGroup PAC ID 1759416662, 1,569 clinicians

Practice addresses (Care Compare)

1400 N Ritter Ave
Indianapolis, IN 46219-3049

555 E County Line Rd
Suite 106
Greenwood, IN 46143-1063
Phone (317) 621-2100

7120 Clearvista Dr
Suite 4000
Indianapolis, IN 46256-1774
Phone (317) 621-7444

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
01067400AINMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Community Physicians of Indiana Inc CurrentSince Aug 22, 2012 Accepting new patients
Community Physicians of Indiana Inc CurrentSince Aug 22, 2012 Accepting new patients
Major Hospital Past Accepting new patients

Locations

5819 Reliable Pkwy
Chicago, IL 60686

555 E County Line Rd
Ste 106
Greenwood, IN 46143
Phone (317) 497-2100

555 E County Line Rd
Ste 107
Greenwood, IN 46143
Phone (317) 497-2100

6626 E 75th St
Ste 500
Indianapolis, IN 46250
Phone (317) 621-7547

7120 Clearvista Dr
Ste 1500
Indianapolis, IN 46256
Phone (317) 621-9292

1400 N Ritter Ave
Ste 351
Indianapolis, IN 46219
Phone (317) 355-2663

6964 Hillsdale Ct
Indianapolis, IN 46250
Phone (317) 621-9292

7120 Clearvista Dr
Ste 4000
Indianapolis, IN 46256
Phone (317) 621-7444

Interoperability endpoints

  • Direct secure messaging: nzulkowski51605@ecommunitydirect.com

Organizations & group practices 3

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": "1207180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1982877569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6626 E 75TH ST",
            "address_2": "SUITE 500",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462502805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7120 CLEARVISTA DR",
            "address_2": "SUITE 1500",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462561621",
            "telephone_number": "317-621-9292",
            "fax_number": "317-621-9299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZULKOWSKI",
        "first_name": "NICOLE",
        "middle_name": "RENEE",
        "name_prefix": "Mrs.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-04-03",
        "last_updated": "2023-11-27",
        "certification_date": "2020-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "IN",
            "license": "01067400A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RR",
            "identifier": "P01157064",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201064020",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nzulkowski51605@eCommunityDirect.com",
            "affiliation": "Y",
            "affiliationName": "Community Physicians of Indiana Inc",
            "address_1": "7120 Clearvista Dr",
            "address_2": "Suite 1500",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "462561621",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.