MRS. ELLY JO FENNELL RN, CNP
NPI 1114245958
Clinical Nurse Specialist in Indianapolis, IN
About Mrs. Elly Jo Fennell Rn, Cnp NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MRS. ELLY JO FENNELL RN, CNP (NPI 1114245958) is an individual clinical nurse specialist in Indianapolis, Indiana, licensed in Indiana (71009460A) and active in the NPI registry since May 2010. She is enrolled in Medicare PECOS, is affiliated with Eskenazi Health, and is a graduate of Other (2009).
NPPES Registry Identity
Specialties & Licenses 4
Other Names 1
Other Identifiers 3
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Mrs. Elly Jo Fennell Rn, Cnp is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignment
Medicare enrollment records show Elly Fennell reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Indianapolis, IN 46202
- Reassigned Medicare billing, Indiana enrollment
- 386 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Areas of Expertise CMS Part B claims
Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.
Hospital Affiliations CMS Care Compare
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Eskenazi Health
Acute Care Hospitals · Indianapolis, INPhysician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 46202 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Medicare Quality Performance CMS QPP · MIPS
Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Elly Fennell's NPI number?
The NPI number for Elly Fennell is 1114245958. It was assigned to this individual provider in the NPPES registry on May 4, 2010. The provider is also known as Elly J Wear.
Where is Elly Fennell located?
Elly Fennell practices at 720 Eskenazi Ave, Indianapolis, IN 46202. The listed phone number is (317) 880-7666.
What is Elly Fennell's specialty?
The primary specialty registered for this NPI is Clinical Nurse Specialist with taxonomy code 364S00000X.
Is Elly Fennell enrolled in Medicare?
Yes. Elly Fennell is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organization bills Medicare for Elly Fennell's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Elly Fennell reassigns Medicare benefits to Eskenazi Medical Group Inc (Indianapolis, IN). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Elly Fennell's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Elly Fennell accept?
Health plans from Anthem Blue Cross and Blue Shield, CareSource and UnitedHealthcare list Elly Fennell as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
Is Elly Fennell affiliated with any hospitals?
According to CMS data, Elly Fennell is affiliated with Eskenazi Health.
When was this NPI record last updated?
The NPPES record for Elly Fennell was last updated on September 16, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Mrs. Elly Jo Fennell, RN, CNP · NPI 1114245958
Clinical Nurse Specialist physician in Indianapolis, Indiana. Individual provider, active in the CMS NPPES registry since May 4, 2010.
## Identity
- **NPI:** 1114245958 (Entity type: Individual)
- **Enumerated:** May 4, 2010
- **Primary specialty:** Clinical Nurse Specialist · taxonomy 364S00000X
- **State license:** 71009460A (Indiana)
- **Sole proprietor:** No
## Practice location
- **Address:** 720 ESKENAZI AVE, Indianapolis, IN 46202-5187
- **Phone:** (317) 880-7666
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Eskenazi Medical Group Inc (NPI 1730451063, Indianapolis, IN), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2009
## Record status
- **NPPES last updated:** September 16, 2025
- **Other identifiers:** Other 209.008173 (IL); Other 041-280081 (IL); Medicaid 036102163 (IL)
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Source: [NPI Profile](https://npiprofile.com/npi/1114245958) · Data from the CMS NPPES public registry.