Angela Luessow, APN is a medicare enrolled "Nurse Practitioner - Psychiatric/mental Health" in Indi, Indiana. Her current practice location is
2040 N Shadeland Ave, Indi, Indiana. You can reach out to her office (for appointments etc.) via phone at
(317) 355-1800.
Angela Luessow is licensed to practice in Indiana (license number 71006396A) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1336693712.
Provider's Profile
| Full Name | Angela Luessow |
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| Gender | Female |
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| Speciality | Nurse Practitioner - Psychiatric/mental Health |
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| Location | 2040 N Shadeland Ave, Indi, Indiana |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1336693712
- Provider Enumeration Date: 08/15/2016
- Last Update Date: 03/19/2024
Medicare PECOS Information:
- PECOS PAC ID: 7315232196
- Enrollment ID: I20160817002712
Medical Identifiers
Medical identifiers for Angela Luessow such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1336693712 | NPI | - | NPPES |
| 201381650 | Medicaid | IN | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 364SP0810X | Clinical Nurse Specialist - Psychiatric/mental Health, Child & Family | 71006396 (Indiana) | Secondary |
| 363LP0808X | Nurse Practitioner - Psychiatric/mental Health | 71006396A (Indiana) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Angela Luessow allows following entities to bill medicare on her behalf.
| Entity Name | Community Health Network Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1336119478
PECOS PAC ID: 1850203977
Enrollment ID: O20031105000554 |
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| Entity Name | The Health And Hospital Corporation Of Marion County |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1104027879
PECOS PAC ID: 6709795974
Enrollment ID: O20041229000426 |
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| Entity Name | Indiana Behavioral Innovations Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1922614825
PECOS PAC ID: 6608286356
Enrollment ID: O20210108000543 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Angela Luessow is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Angela Luessow, APN
6626 E 75th Street, Suite 500,
Indianapolis, IN 46250-2890
Ph: () - | Angela Luessow, APN
2040 N Shadeland Ave,
Indi, IN 46219-1734
Ph: (317) 355-1800 |
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