Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Lily Indrawati, CRNP

Individual provider Family Nurse Practitioner · NPI 1932865417

Lily Indrawati, CRNP is a Nurse Practitioner in Scranton, Pennsylvania. Qualified in 2021, 5 years ago. Practices with Pennsylvania Hospitalist Group, LLC, a 59-clinician group and accepts Medicare assignment. Licensed in Pennsylvania.

Years since qualifying
5
Licensed in
PA
In the registry since
2021
What do these letters mean?
CRNP — Certified Registered Nurse Practitioner
The title Pennsylvania and some other states use for a nurse practitioner.

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Practice location Address checks out

746 Jefferson Ave
Scranton, PA 18510-1624
Phone: (570) 770-3000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence SP024210 (PA)

Record details

NPI number1932865417
Entity typeIndividual (Type 1)
GenderFemale
Credentials CRNP
Sole proprietorNo
NPI enumeratedNovember 9, 2021
Last updated in NPPESNovember 9, 2021
Certification dateNovember 9, 2021
Mailing address746 Jefferson Ave, Scranton, PA 18510-1624

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Pennsylvania Hospitalist Group, Llc — 59 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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