Individual provider Active NPI

Jenette Buening, PA-C

  • Physician Assistant
  • Indianapolis, IN
National Provider Identifier
1003969510
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
10000577A Issued in IN
Practice address
5545 E Stop 11 Rd
Indianapolis, IN 46237-8616
Phone
(317) 497-6800
Fax
(317) 497-6801
NPI assigned
Jan 19, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 10000577A IN Primary

Addresses

Primary practice location

5545 E Stop 11 Rd
Indianapolis, IN 46237-8616

Mailing address

6626 E. 75TH Street
Suite 500
Indianapolis, IN 46250-2890

Other identifiers 1

IdentifierTypeStateIssuer
300005094MedicaidIN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jbuening6802@eCommunityDirect.com Community Hospitals of Indiana, INC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040920001222 IN Practitioner - Physician Assistant 6709854557 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
10000577AINMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Community Physicians of Indiana Inc CurrentSince Dec 1, 2011 Accepting new patients
Major Hospital Past Accepting new patients

Locations

5819 Reliable Pkwy
Chicago, IL 60686

679 E County Line Rd
Greenwood, IN 46143
Phone (317) 807-1262

5545 E Stop 11 Rd
Indianapolis, IN 46237
Phone (317) 497-6800

6626 E 75th St
Ste 500
Indianapolis, IN 46250
Phone (317) 621-7547

7120 Clearvista Dr
Ste 4000
Indianapolis, IN 46256
Phone (317) 621-7444

Interoperability endpoints

  • Direct secure messaging: jbuening6802@ecommunitydirect.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1169164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1003969510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6626 E. 75TH STREET",
            "address_2": "SUITE 500",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462502890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5545 E STOP 11 RD",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462378616",
            "telephone_number": "317-497-6800",
            "fax_number": "317-497-6801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUENING",
        "first_name": "JENETTE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-19",
        "last_updated": "2023-11-27",
        "certification_date": "2020-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IN",
            "license": "10000577A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300005094",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jbuening6802@eCommunityDirect.com",
            "affiliation": "Y",
            "affiliationName": "Community Hospitals of Indiana, INC",
            "address_1": "5545 E Stop 11 Rd",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "462378616",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.