Mrs Elly Jo Fennell, RN, CNP in Indianapolis, IN

Mrs Elly Jo Fennell, RN, CNP is a medicare enrolled "Clinical Nurse Specialist" in Indianapolis, Indiana. She graduated from nursing school in 2009 and has 15 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Eskenazi Medical Group Inc and her current practice location is 720 Eskenazi Ave, Indianapolis, Indiana. You can reach out to her office (for appointments etc.) via phone at (317) 880-7666.

Mrs Elly Jo Fennell is licensed to practice in Indiana (license number 71009460A) and she also participates in the medicare program. She accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1114245958.

Contact Information

	Mrs Elly Jo Fennell, RN, CNP
	720 Eskenazi Ave, Indianapolis, IN 46202-5187
	(317) 880-7666
	Not Available

Map and Direction

Provider's Profile

Full Name	Mrs Elly Jo Fennell
Gender	Female
Speciality	Nurse Practitioner
Experience	15 Years
Location	720 Eskenazi Ave, Indianapolis, Indiana
Accepts Medicare Assignments	Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.

Medical Education and Training:

Mrs Elly Jo Fennell graduated from nursing school in 2009

NPI Data:

NPI Number: 1114245958
Provider Enumeration Date: 05/04/2010
Last Update Date: 11/18/2021

Medicare PECOS Information:

PECOS PAC ID: 6103013602
Enrollment ID: I20191113002644

Medical Identifiers

Medical identifiers for Mrs Elly Jo Fennell such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1114245958	NPI	-	NPPES
041-280081	Other	IL	RN LICENSE
036102163	Medicaid	IL
209.008173	Other	IL	CNP LICENSE

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363L00000X	Nurse Practitioner	209.008173 (Illinois)	Secondary
363LA2200X	Nurse Practitioner - Adult Health	209.008173 (Illinois)	Secondary
363LA2200X	Nurse Practitioner - Adult Health	370911138 (Illinois)	Secondary
364S00000X	Clinical Nurse Specialist	71009460A (Indiana)	Primary
163W00000X	Registered Nurse	041-280081 (Illinois)	Secondary

Medical Facilities Affiliation

Facility Name	Location	Facility Type
Eskenazi Health	Indianapolis, IN	Hospital

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Eskenazi Medical Group Inc	4284546813	119

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. Mrs Elly Jo Fennell allows following entities to bill medicare on her behalf.

Entity Name	Eskenazi Medical Group Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1730451063 PECOS PAC ID: 4284546813 Enrollment ID: O20031103000440

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. Mrs Elly Jo Fennell 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
Mrs Elly Jo Fennell, RN, CNP 3900 St Francis Way Ste 205, Lafayette, IN 47905-4939 Ph: (765) 428-2500	Mrs Elly Jo Fennell, RN, CNP 720 Eskenazi Ave, Indianapolis, IN 46202-5187 Ph: (317) 880-7666

Reviews and Comments

Clinical Nurse Specialist Nurses in Indianapolis, IN

Sheryl Ann Terzini, CNS Clinical Nurse Specialist Medicare: Accepting Medicare Assignments Practice Location: 7250 Clearvista Drive, Suite 227, Indianapolis, IN 46256 Phone: 317-621-7804 Fax: 317-621-7275
Johnny Valito Toles Sr., LPN Clinical Nurse Specialist Medicare: Not Enrolled in Medicare Practice Location: 1635 N Arlington Ave, Indianapolis, IN 46218 Phone: 317-353-6000
Megan Zondor, Clinical Nurse Specialist Medicare: Not Enrolled in Medicare Practice Location: 1701 N Senate Ave, Indianapolis, IN 46202 Phone: 317-847-0991
Jennifer L Dickinson, NP Clinical Nurse Specialist Medicare: Not Enrolled in Medicare Practice Location: 720 Eskenazi Ave, Indianapolis, IN 46202 Phone: 317-880-8211
David Beatty, Clinical Nurse Specialist Medicare: Not Enrolled in Medicare Practice Location: 1001 W 10th St, Indianapolis, IN 46202 Phone: 317-630-8485
Ms. Raenita D Mears, MSN RN Clinical Nurse Specialist Medicare: Not Enrolled in Medicare Practice Location: 1481 W 10th St, Indianapolis, IN 46202 Phone: 317-988-9013
Dr. Alyson Yvonne Keen, PHD, RN, ACNS-BC Clinical Nurse Specialist Medicare: Not Enrolled in Medicare Practice Location: 1701 N Senate Ave, Indianapolis, IN 46202 Phone: 317-341-3060

Mrs Elly Jo Fennell, RN, CNP - Medicare Nurse Practitioner in Indianapolis, IN