KATELYNN CRULL
NPI 1114883386
Nurse Practitioner - Family in Fort Wayne, IN

Q: What is Katelynn Crull's NPI number?

The NPI number for Katelynn Crull is 1114883386. It was assigned to this individual provider in the NPPES registry on December 31, 2025.

Q: What is Katelynn Crull's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Q: When was this NPI record last updated?

The NPPES record for Katelynn Crull was last updated on January 15, 2026. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since December 31, 2025PECOS EnrolledAccepts Medicare Assignment

3512 STELLHORN RD, FORT WAYNE, IN 46815(855) 743-2247 Get Directions Write a Review

NPPES record last updated: January 15, 2026. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jan 15, 2026, Dec 31, 2025 (2 updates tracked since 2025).

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About Katelynn Crull NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KATELYNN CRULL (NPI 1114883386) is an individual family provider in Fort Wayne, Indiana, licensed in Indiana (71017639A) and active in the NPI registry since December 2025. She is enrolled in Medicare PECOS and is a graduate of Other (2025).

NPPES Registry Identity

NPI1114883386

Entity TypeIndividualFemale

Primary Taxonomy363LF0000X

Provider Legal NameKATELYNN CRULL

Location Address3512 STELLHORN RDFort Wayne, IN 46815-4631

Mailing AddressPo Box 1431, Dept 400Charlotte, NC 28201-1431

Phone(855) 743-2247

Sole ProprietorNo

Medical School CMSOtherGraduated 2025

Enumeration DateDecember 31, 2025

Last NPPES UpdateJanuary 15, 20262 updates tracked since enumeration

NPPES CertifiedJanuary 15, 2026

✔ NPI 1114883386 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

License✔ Licensed in IN · 71017639A

3512 STELLHORN RD, Fort Wayne, IN 46815

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Katelynn Crull 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.

PECOS PAC ID1355823220

PECOS Enrollment IDI20260302000877

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 46815 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$82.04 typical visit price

range $53.07 – $161.76

Typical copayment $20.51 (range $13.26 – $40.44)

Most-billed visit code 99203

Established Patient

$94.22 typical visit price

range $16.93 – $132.22

Typical copayment $23.55 (range $4.23 – $33.05)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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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.

MRS. LHYRA DAWIS MAYORALGO PT

Contractor