Ellise Suzanne Koenn, NP - Medicare Nurse Practitioner in Fort Wayne, IN

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Ellise Suzanne Koenn, NP is a medicare enrolled "Nurse Practitioner - Family" physician in Fort Wayne, Indiana. Her current practice location is 10228 Dupont Circle Dr E Ste 100, Fort Wayne, Indiana. You can reach out to her office (for appointments etc.) via phone at (260) 222-7401.

Ellise Suzanne Koenn is licensed to practice in Indiana (license number 71012516A) 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 1952897092.

Contact Information

Ellise Suzanne Koenn, NP
10228 Dupont Circle Dr E Ste 100,
Fort Wayne, IN 46825-1611
(260) 222-7401
(260) 209-5956

Map and Direction




Physician's Profile

Full NameEllise Suzanne Koenn
GenderFemale
SpecialityNurse Practitioner - Family
Location10228 Dupont Circle Dr E Ste 100, Fort Wayne, Indiana
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1952897092
  • Provider Enumeration Date: 07/02/2018
  • Last Update Date: 02/01/2023
  Medicare PECOS Information:
  • PECOS PAC ID: 8527317692
  • Enrollment ID: I20180822002780

Medical Identifiers

Medical identifiers for Ellise Suzanne Koenn such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1952897092NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207Q00000XFamily Medicine APRN.CNP.023023 (Ohio)Secondary
363LF0000XNurse Practitioner - Family 71012516A (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. Ellise Suzanne Koenn allows following entities to bill medicare on her behalf.
Entity NameCommunity Memorial Hospital
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1730145392
PECOS PAC ID: 0547258907
Enrollment ID: O20040504000912

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. Ellise Suzanne Koenn 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 AddressPractice Location Address
Ellise Suzanne Koenn, NP
Po Box 772437,
Detroit, MI 48277-2437

Ph: (317) 575-7304		Ellise Suzanne Koenn, NP
10228 Dupont Circle Dr E Ste 100,
Fort Wayne, IN 46825-1611

Ph: (260) 222-7401

Reviews and Comments



Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.