Individual provider Active NPI

Nikola Cengelova Conrad, M.D.

  • Family Medicine Physician
  • Jasper, IN
National Provider Identifier
1013279371
Registry record updated Mar 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
01082207A Issued in IN
Practice address
966 Bartley St
Jasper, IN 47546-2641
Phone
(812) 996-7810
Fax
(812) 996-8465
NPI assigned
Jun 13, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 01082207A IN Primary

Addresses

Primary practice location

966 Bartley St
Jasper, IN 47546-2641

Mailing address

PO Box 631767
Cincinnati, OH 45263-1767
Phone (812) 450-6815

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190606002418 IN Practitioner - Family Practice 5991018376 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Deaconess Clinic IncGroup PAC ID 3375610116, 411 clinicians

Practice addresses (Care Compare)

966 Bartley St
Jasper, IN 47546-2641
Phone (812) 996-7810

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Deaconess Clinic, Inc Family Medicine CurrentSince Jan 7, 2026 Accepting new patients
Deaconess Clinic Inc Family Medicine CurrentSince Jan 7, 2026 Accepting new patients
Deaconess Memorial Medical Center Inc Family Medicine Current Accepting new patients
Deaconess Memorial Medical Center Inc Family Medicine CurrentSince Jun 17, 2019 Accepting new patients
Deaconess Memorial Medical Center Inc CurrentSince Jun 17, 2019 Accepting new patients
Deaconess Clinic, Inc Family Medicine Past Accepting new patients
Deaconess Memorial Medical Center Inc Past Accepting new patients

Locations

421 Chestnut St
Evansville, IN 47713
Phone (812) 426-6645

966 Bartley St
Jasper, IN 47546
Phone (812) 996-5425

800 W 9th St
Jasper, IN 47546
Phone (812) 482-2345

Interoperability endpoints

  • Direct secure messaging: nconrad1044807@direct.deaconess.com

Organizations & group practices 8

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1339545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772668800000",
    "number": "1013279371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 631767",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452631767",
            "telephone_number": "812-450-6815",
            "fax_number": "812-450-6822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "966 BARTLEY ST",
            "city": "JASPER",
            "state": "IN",
            "postal_code": "475462641",
            "telephone_number": "812-996-7810",
            "fax_number": "812-996-8465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONRAD",
        "first_name": "NIKOLA",
        "middle_name": "CENGELOVA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-13",
        "last_updated": "2026-03-05",
        "certification_date": "2026-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01082207A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jasper, IN

Sources for this page

Verify at the official NPI Registry.