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KELLY R DOMENECH NP
NPI 1538048376
Nurse Practitioner - Psychiatric/Mental Health in Indianapolis, IN

Active since August 27, 2025PECOS EnrolledAccepts Medicare Assignment
355 W 16TH ST STE 2800, INDIANAPOLIS, IN 46202(317) 963-7300(317) 963-7075 Get Directions Write a Review

NPPES record last updated: September 9, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Kelly R Domenech Np NPPES

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

KELLY R DOMENECH NP (NPI 1538048376) is an individual psychiatric/mental health provider in Indianapolis, Indiana, licensed in Indiana (71017023A) and active in the NPI registry since August 2025. She is enrolled in Medicare PECOS, maintains a secondary practice location in Indianapolis, and is a graduate of Other (2025).

NPPES Registry Identity

NPI1538048376
Entity TypeIndividualFemale
Primary Taxonomy363LP0808X
Provider Legal NameKELLY R DOMENECHCredential: NP
Location Address355 W 16TH ST STE 2800Indianapolis, IN 46202-2279
Mailing Address355 W 16th St Ste 2800Indianapolis, IN 46202-2279 · (317) 963-7300 · Fax (317) 963-7075
Phone(317) 963-7300
Fax(317) 963-7075
Sole ProprietorNo
Medical School CMSOtherGraduated 2025
Enumeration DateAugust 27, 2025
Last NPPES UpdateSeptember 9, 2025
NPPES CertifiedSeptember 9, 2025
✔ NPI 1538048376 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0808X
License✔ Licensed in IN · 71017023A
Also ListedNurse PractitionerTaxonomy 363L00000X · License 71017023A (IN)
355 W 16TH ST STE 2800, Indianapolis, IN 46202
Open in Google Maps ↗

Secondary Practice Location 1

Location 1550 University BlvdIndianapolis, IN 46202-5149 · Phone (317) 944-5998

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, CareSource, Cigna Healthcare and more.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

Kelly R Domenech Np 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 ID6305340142
PECOS Enrollment IDI20250916002732
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.

Medicare Billing Reassignment

Medicare enrollment records show Kelly Domenech reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Iu Health Medical Group, LLC
0.2 mi
General Practice
1701 N SENATE BLVD
Indianapolis, IN 46202
  • Reassigned Medicare billing, Indiana enrollment
  • 5,212 clinicians in this Medicare group
NPI 1326893777 (317) 962-2000

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician 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.

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.

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.

RACHEL LYN GUNN PHD
Psychologist (Clinical)
355 W 16TH ST STE 2800
INDIANAPOLIS, IN 46202
Marion County (317) 963-7300
OLAWALE O OJO M.B.CH.B
Psychiatry & Neurology (Psychiatry)
355 W 16TH ST STE 2800
INDIANAPOLIS, IN 46202
Marion County (317) 963-7300
DAWN RENAE GOODMAN-MARTIN M.A., LMHC, NCC
Counselor (Mental Health)
355 W 16TH ST STE 2800
INDIANAPOLIS, IN 46202
Marion County (317) 963-7300
MATTEO RESPINO MD
Psychiatry & Neurology (Psychiatry)
355 W 16TH ST STE 2800
INDIANAPOLIS, IN 46202
Marion County (317) 963-7300
DR. DHRUMIL SURYAKANT PATEL MD
Psychiatry & Neurology (Psychiatry)
355 W 16TH ST STE 2800
INDIANAPOLIS, IN 46202
Marion County (317) 963-7300
DANIELLE KAYE ROBINSON NP
Nurse Practitioner (Psychiatric/Mental Health)
355 W 16TH ST STE 2800
INDIANAPOLIS, IN 46202
Marion County (317) 963-7300
TYLER JOSEPH WILLIAM HECHT MD
Psychiatry & Neurology (Addiction Psychiatry)
355 W 16TH ST STE 2800
INDIANAPOLIS, IN 46202
Marion County (317) 963-7310
KAELA LOISE STUART
Student in an Organized Health Care Education/Training Program
355 W 16TH ST STE 2800
INDIANAPOLIS, IN 46202
Marion County (317) 963-7038

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 Kelly Domenech's NPI number?

The NPI number for Kelly Domenech is 1538048376. It was assigned to this individual provider in the NPPES registry on August 27, 2025.

Where is Kelly Domenech located?

Kelly Domenech practices at 355 W 16th St Ste 2800, Indianapolis, IN 46202. The listed phone number is (317) 963-7300.

What is Kelly Domenech's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Is Kelly Domenech enrolled in Medicare?

Yes. Kelly Domenech 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 Kelly Domenech's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Kelly Domenech reassigns Medicare benefits to Iu Health Medical Group, LLC (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 Kelly Domenech's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Kelly Domenech accept?

Health plans from Anthem Blue Cross and Blue Shield, CareSource, Cigna Healthcare and UnitedHealthcare list Kelly Domenech 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.

When was this NPI record last updated?

The NPPES record for Kelly Domenech was last updated on September 9, 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.