MS. NANCY JO FANTETTI (FNP) – Family Nurse Practitioner, NPI 1891054458

MS. NANCY JO FANTETTI (FNP) is a healthcare provider. based in Mishawaka, Indiana. specializing in NURSE PRACTITIONER. They hold the professional credentials FNP. They hold a License No. 28125230A (IN). The NPI Number for MS. NANCY JO FANTETTI (FNP) is 1891054458

Main info

Female
15 Years Of Experience
Accepts Medicare Assignment
Name
MS. NANCY JO FANTETTI (FNP)
NPI
1891054458
Phone
(219) 462-7173
Address
420 W 4th St
Enumeration Date
16 May 2012
Last Update Date
15 August 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2696870200
Graduation Year
2011 (15 years ago)
PAC ID
0244485639
Group Practice PAC ID
7416942750
Professional Enrollment ID
I20130727000175
Address ID
MI491204074NI2002XSTXX400
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience61
Completeness75
Years active:14State licenses:2Digital endpointsOther names

8,191 NURSE PRACTITIONER in IN

Provider Addresses for MS. NANCY JO FANTETTI (FNP)

  • 420 W 4th St

    Mishawaka, IN 465441948

    Phone: (219) 462-7173

    Type: Location

  • 2002 S 11TH ST

    NILES, MI 491204074

    Phone: (269) 687-0200

    Fax: (269) 684-0199

    Type: Location

  • 454 S COLLEGE AVE

    VALPARAISO, IN 463836512

    Phone: (219) 462-7173

    Type: Mailing

  • 420 W 4TH ST

    MISHAWAKA, IN 465441948

    Phone: (219) 462-7173

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 31 Open Payments records for all available years, with a total value of $528.

Total Amount is formed as General ($528) + Research ($0) + Ownership ($0) = $528.

Last reported payment date: 2024-11-20 • Largest payer in this snapshot: Boehringer Ingelheim Pharmaceuticals, Inc. ($54).

Total Amount

$528

General + Research + Ownership

Payments

31

Total payment records

General Amount

$528

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-11-20

Latest reported date

View all Open Payments →|Open Payments Risk Radar →

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: 2013-07-27

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20130727000175INurse PractitionerMITBD

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.

Verify on CMS Revalidation Lookup Tool

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 46544)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 7416942750View full group profile
NameSpecialtyState
-MI
Clinical PsychologistPA
Family PracticeMI
Internal MedicineMI
Nurse PractitionerMI
Nurse PractitionerMI
Physician AssistantMI
Family PracticeMI
Nurse PractitionerMI
Nurse PractitionerMI

Reviews

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Frequently asked questions

What unique ID ties claims to MS. NANCY JO FANTETTI (FNP)?
NPI 1891054458 is assigned to MS. NANCY JO FANTETTI (FNP) under the national enumeration system.
Is MS. NANCY JO FANTETTI (FNP)'s NPI currently valid?
The extract we use shows MS. NANCY JO FANTETTI (FNP) as active.
What kind of provider is MS. NANCY JO FANTETTI (FNP)?
The page reflects Family Nurse Practitioner for MS. NANCY JO FANTETTI (FNP). Clinical services aligned with this taxonomy classification.
What location shows for MS. NANCY JO FANTETTI (FNP)?
We surface Mishawaka, Indiana for MS. NANCY JO FANTETTI (FNP) based on available NPPES addresses.
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

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