1. Home
  2. Directory
  3. Indiana
  4. Polis
  5. Student In An Organized Health Care Education Training Program
  6. NPI Profile

NICHOLAS REDILLA III
NPI 1164236188
Student in an Organized Health Care Education/Training Program in Indianapolis, IN

Active since February 03, 2025PECOS Enrolled
1040 WISHARD BLVD, INDIANAPOLIS, IN 46202(317) 278-7930 Get Directions Write a Review

NPPES record last updated: May 22, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: May 22, 2026, Feb 3, 2025 (2 updates tracked since 2025).

About Nicholas Redilla Iii NPPES

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

NICHOLAS REDILLA III (NPI 1164236188) is an individual student in an organized health care education/training program in Indianapolis, Indiana, licensed in Indiana (11024927A) and active in the NPI registry since February 2025. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1164236188
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameNICHOLAS REDILLA III
Location Address1040 WISHARD BLVDIndianapolis, IN 46202-2872
Mailing Address1040 Wishard BlvdIndianapolis, IN 46202-2872
Phone(317) 278-7930
Sole ProprietorNo
Enumeration DateFebruary 3, 2025
Last NPPES UpdateMay 22, 20262 updates tracked since enumeration
NPPES CertifiedMay 22, 2026
✔ NPI 1164236188 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
License✔ Licensed in IN · 11024927A
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
1040 WISHARD BLVD, Indianapolis, IN 46202
Open in Google Maps ↗

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Nicholas Redilla Iii is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

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.

RUBEN HERNAN HERNANDEZ MONDRAGON MD
Family Medicine
1040 WISHARD BLVD
INDIANAPOLIS, IN 46202
Marion County (317) 962-8893
DR. ZACHARY COLE WAGNER DO
Student in an Organized Health Care Education/Training Program
1040 WISHARD BLVD, DUNLAP BUILDING
INDIANAPOLIS, IN 46202
Marion County (317) 278-1090
ANIKA TAHSIN SHAFIE MD
Student in an Organized Health Care Education/Training Program
1040 WISHARD BLVD
INDIANAPOLIS, IN 46202
Marion County (317) 278-1090
LAUREN LUCAS MD
Student in an Organized Health Care Education/Training Program
1040 WISHARD BLVD
INDIANAPOLIS, IN 46202
Marion County (317) 278-1090
LEA FEGHALI
Student in an Organized Health Care Education/Training Program
1040 WISHARD BLVD
INDIANAPOLIS, IN 46202
Marion County (317) 962-8893
MAITE BASTYR MD
Student in an Organized Health Care Education/Training Program
1040 WISHARD BLVD
INDIANAPOLIS, IN 46202
Marion County (317) 963-4634
ALLISON MARIE TANN NP
Nurse Practitioner (Family)
1040 WISHARD BLVD
INDIANAPOLIS, IN 46202
Marion County (317) 962-8893
DR. AXELLE MAYODE ATCHADE MD
Student in an Organized Health Care Education/Training Program
1040 WISHARD BLVD
INDIANAPOLIS, IN 46202
Marion County (317) 278-1090

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 Nicholas Redilla's NPI number?

The NPI number for Nicholas Redilla is 1164236188. It was assigned to this individual provider in the NPPES registry on February 3, 2025.

Where is Nicholas Redilla located?

Nicholas Redilla practices at 1040 Wishard Blvd, Indianapolis, IN 46202. The listed phone number is (317) 278-7930.

What is Nicholas Redilla's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Nicholas Redilla enrolled in Medicare?

Yes. Nicholas Redilla is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Nicholas Redilla was last updated on May 22, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.