TARA LEE NIMTZ – Nurse Practitioner, NPI 1104437631
Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
8,191 NURSE PRACTITIONER in IN
Provider Addresses for TARA LEE NIMTZ
2022 KELLE DR
CHESTERTON, IN 463048708
Phone: (219) 364-4004
Fax: (219) 326-2584
Type: Mailing
701 W TALMER AVE
NORTH JUDSON, IN 463661335
Phone: (574) 896-5533
Type: Location
400 TEEGARDEN ST
LA PORTE, IN 463503175
Phone: (219) 326-0043
Fax: (219) 326-8909
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 4 Open Payments records for all available years, with a total value of $98.
Total Amount is formed as General ($98) + Research ($0) + Ownership ($0) = $98.
Last reported payment date: 2024-10-17 • Largest payer in this snapshot: ABBVIE INC. ($75).
Total Amount
$98
General + Research + Ownership
Payments
4
Total payment records
General Amount
$98
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-10-17
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| ABBVIE INC. | $75 |
| Gilead Sciences, Inc. | $23 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2020-10-12
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20201012001646 | I | Nurse Practitioner | IN | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 83036 | Hemoglobin a1c level | 19 | 15 | $0 |
Insurance plans in this area (ZIP 46304)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Mental Health Counselor | IN | |
| Family Practice | DC | |
| Nurse Practitioner | IN | |
| Nurse Practitioner | IN | |
| - | IN | |
| Family Practice | IN | |
| Nurse Practitioner | MI | |
| - | IN | |
| Nurse Practitioner | IN | |
| - | IN |
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