Jacquiline N Greenwald, APRN

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

71005524A Issued in IN

Practice address

3830 E Southport Rd Ste 800
Indianapolis, IN 46237-3265

Phone

(317) 809-3755

NPI assigned

Mar 24, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in IN, FL2 enrollments

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 2

Merit-based Incentive Payment System (MIPS)

Final score

93.78 of 100Reported as apm

Quality

80.38

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Networks

• Freedom Health HMO Network
• Optimum HealthCare HMO Network

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.

• Riverview Hospital

  • Family Medicine Physician
  • Noblesville, IN
  • NPI 1609074921
  Medicare reassignment NPD
• Millennium Physician Group LLC

  • Family Medicine Physician
  • Fort Myers, FL
  • NPI 1811122880
  Medicare reassignment NPD
• Anew Palliative Care LLC

  • Nursing Care Agency
  • Indianapolis, IN
  • NPI 1881325967
  NPD
• Riverview Hospital

  • Skilled Nursing Facility
  • Indianapolis, IN
  • NPI 1831164995
  NPD
• Millennium Physician Group LLC

  • Family Medicine Physician
  • Brooksville, FL
  • NPI 1073131702
  NPD
• Transitions Indiana, LLC

  • Community Based Hospice Care Agency
  • Indianapolis, IN
  • NPI 1376998781
  NPD (past)
• Millennium Physician Group LLC

  • Family Medicine Physician
  • N Fort Myers, FL
  • NPI 1063184711
  NPD (past)

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

{
    "created_epoch": "1427155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695340800000",
    "number": "1083008494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3830 E SOUTHPORT RD STE 800",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462373265",
            "telephone_number": "131-780-9375",
            "fax_number": "239-599-2612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3830 E SOUTHPORT RD STE 800",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462373265",
            "telephone_number": "317-809-3755"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "395 Westfield Rd",
            "address_purpose": "LOCATION",
            "city": "Noblesville",
            "state": "IN",
            "postal_code": "460601434",
            "country_code": "US",
            "telephone_number": "317-773-0760",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GREENWALD",
        "first_name": "JACQUILINE",
        "middle_name": "N",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-24",
        "last_updated": "2023-09-22",
        "certification_date": "2023-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "IN",
            "license": "71005524A",
            "primary": true
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "FL",
            "license": "APRN9483846",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201293510",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100277200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Matthew Claude Greenlee, MSW, LCSW
• Carol D Greenspan, MD
• Elicia Greenspan, LCSW
• Jeffrey S Greenspan, MD
• Ebony Greenwade, LMT, MMP
• Martha L Greenwald, NP
• Amy E Greenwell, OTR
• Greenwood Dental Health, LLC
• Greenwood Orthopedics PC
• Greenwood Pediatrics PC

• Adult Health Nurse Practitioner in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Adult Health Nurse Practitioner in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2023; 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.