Jared L Brock, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

10000575A Issued in IN

Practice address

4001 W Goeller Blvd Ste a
Columbus, IN 47201-8309

Phone

(812) 375-3330

Fax

(812) 375-3329

NPI assigned

Jun 2, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Electronic endpoints 1

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

Specialty

Physician Assistant

Education

Other, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Columbus Regional Health Physicians LLCGroup PAC ID 1052612314, 216 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• American Nursing Care LLC Home health agency, Columbus, IN, CCN 157077
• Columbus Regional Hospital Hospital, Columbus, IN, CCN 150112

Merit-based Incentive Payment System (MIPS)

Final score

93.97 of 100Reported as apm

Quality

85.1

Promoting interoperability

94.69

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jbrock8286@edirect.crh.org

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.

• Columbus Regional Health Physicians, LLC

  • Internal Medicine Physician
  • Columbus, IN
  • NPI 1336510098
  Medicare reassignment Care Compare group NPD
• Columbus Regional Health Physicians, LLC

  • Family Medicine Physician
  • Columbus, IN
  • NPI 1740650225
  NPD
• Columbus Regional Health Physicians, LLC

  • Family Medicine Physician
  • Columbus, IN
  • NPI 1902276488
  NPD (past)
• Columbus Urgent Care Center

  • Family Medicine Physician
  • Columbus, IN
  • NPI 1548338635
  NPD (past)
• Icem, LLC

  • Emergency Medicine Physician
  • Indianapolis, IN
  • NPI 1467788208
  NPD (past)
• Johnson Memorial Hospital

  • Internal Medicine Physician
  • Franklin, IN
  • NPI 1154321099
  NPD (past)
• Methodist Medical Group Physicians Inc

  • Family Medicine Physician
  • Indianapolis, IN
  • NPI 1285673616
  NPD (past)
• Payne Park Inpatient Services LLC

  • Internal Medicine Physician
  • Franklin, IN
  • NPI 1487925343
  NPD (past)

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

• American Nursing Care, LLC

  • Home Health Agency
  • Columbus, IN
  • NPI 1093748402
  Care Compare affiliation
• Columbus Regional Hospital

  • General Acute Care Hospital
  • Columbus, IN
  • NPI 1104998624
  Care Compare affiliation

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

{
    "created_epoch": "1149206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725840000000",
    "number": "1073551248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 775383",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606775383",
            "telephone_number": "812-376-5315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4001 W GOELLER BLVD STE A",
            "city": "COLUMBUS",
            "state": "IN",
            "postal_code": "472018309",
            "telephone_number": "812-375-3330",
            "fax_number": "812-375-3329"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROCK",
        "first_name": "JARED",
        "middle_name": "L",
        "name_prefix": "Mr.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-02",
        "last_updated": "2024-09-09",
        "certification_date": "2024-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IN",
            "license": "10000575A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIANA LICENSE",
            "identifier": "10000575A",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM PIN",
            "identifier": "000000991456",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jbrock8286@edirect.crh.org",
            "affiliation": "N",
            "endpointDescription": "direct Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Direct Address",
            "address_1": "4001 W Goeller Blvd Ste A",
            "city": "Columbus",
            "state": "IN",
            "country_code": "US",
            "postal_code": "472018309",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Sarah Bringman, NP
• Roger Brinkman, LCSW
• Dorajo Brittain, RBT
• Taylor Brittain
• Amanda Marie Brock, LCSW, LCAC
• Megan Brock, PA
• Natasha Rose Brockhaus, B.S., IBCLC
• Austin Brockman
• Mackenzie Broman, RBT
• Elizabeth Brookover, RBT

• Physician Assistant in Columbus, IN
• Providers in Columbus, IN by specialty
• Physician Assistant in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.