Individual provider Active NPI

Jason P Palmateer, FNP

  • Family Nurse Practitioner
  • Mishawaka, IN
National Provider Identifier
1083695332
Registry record updated Nov 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
71001595B Issued in IN
Practice address
5340 Holy Cross Pkwy
Mishawaka, IN 46545-1470
Phone
(574) 237-1328
Fax
(574) 237-1348
NPI assigned
Nov 11, 2005
Last updated
Nov 15, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 71001595B IN Primary

Addresses

Primary practice location

5340 Holy Cross Pkwy
Mishawaka, IN 46545-1470

Mailing address

PO Box 746092
Atlanta, GA 30374-6092
Phone (574) 334-5400

Other identifiers 2

IdentifierTypeStateIssuer
200862230MedicaidIN
000000730740OtherINANTHEM

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
I20080325000269 IN Practitioner - Nurse Practitioner 9335225853 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Michiana Hematology-Oncology P CGroup PAC ID 3375513419, 13 clinicians

Practice addresses (Care Compare)

5340 Holy Cross Pkwy
Mishawaka, IN 46545-1470
Phone (574) 237-1328

Merit-based Incentive Payment System (MIPS)

Final score
98.47 of 100Reported as group
Quality
91.94
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
71001595BINMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Michiana Hematology-Oncology P C CurrentSince May 9, 2022 Accepting new patients
Michiana Hematology-Oncology P C CurrentSince May 9, 2022 Accepting new patients
Byron M. Holm, MD Past Accepting new patients
Saint Joseph Regional Medical Center, Inc. Past Accepting new patients
Saint Joseph Regional Medical Center- Plymouth Campus Inc Family Past Accepting new patients

Locations

1506 Osolo Rd
#A
Elkhart, IN 46514
Phone (574) 295-1131

5340 Holy Cross Pkwy
Mishawaka, IN 46545
Phone (574) 237-1328

1915 Lake Ave
Plymouth, IN 46563
Phone (219) 936-3181

2855 Miller Dr
Ste 119
Plymouth, IN 46563
Phone (574) 941-1000

Organizations & group practices 5

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

NPI Registry JSON

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

{
    "created_epoch": "1131667200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700006400000",
    "number": "1083695332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 746092",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303746092",
            "telephone_number": "574-334-5400",
            "fax_number": "574-237-1348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5340 HOLY CROSS PKWY",
            "city": "MISHAWAKA",
            "state": "IN",
            "postal_code": "465451470",
            "telephone_number": "574-237-1328",
            "fax_number": "574-237-1348"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALMATEER",
        "first_name": "JASON",
        "middle_name": "P",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-11",
        "last_updated": "2023-11-15",
        "certification_date": "2023-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71001595B",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200862230",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000730740",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mishawaka, IN

Sources for this page

Verify at the official NPI Registry.