Active NPI
Peter C Jenkins, MD
- Surgery Physician
- Indianapolis, IN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 01074216A
- Practice address
- 1701 N Senate Blvd
Indianapolis, IN 46202-1239 - Phone
- (317) 630-7582
- Fax
- (317) 630-7694
- NPI assigned
- Jan 4, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 4301101564 | MI | |
| Surgery Physician | 208600000X | MT185869 | PA | |
| Surgical Critical Care Physician | 2086S0102X | 01074216A | IN | |
| Surgery Physician | 208600000X | 01074216A | IN | Primary |
Addresses
Primary practice location
1701 N Senate Blvd
Indianapolis, IN 46202-1239
Mailing address
250 N Shadeland Ave
Indianapolis, IN 46219-4959
Other practice location 1
1801 N Senate Blvd.
Suite 635
Indianapolis, IN 46202-1239
Phone (317) 963-1400
Other practice location 2
2401 W University Ave
Muncie, IN 47303-3428
Phone (765) 289-6381
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 201233600 | Medicaid | IN |
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | pjenkins1@direct.iuhealth.org | Direct | |
| Direct Messaging Address | pjenkins1@direct.iuhealth.org | Direct |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- General Surgery
- Education
- Perelman School of Med at the University of Pennsylvania, 2005
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1701 N Senate Blvd
Indianapolis, IN 46202-1239
Phone (317) 944-5000
550 University Blvd
Indianapolis, IN 46202-5149
Hospital & facility affiliations
- Indiana University Health
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of tissue | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01074216A | IN | MD | Surgery Physician |
| 4301101564 | MI | MD | Surgery Physician |
| MT185869 | PA | MD | Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Iu Health Medical Group, LLC | Current | Accepting new patients | |
| Indiana University Health Ball Memorial Physicians, Inc. | Surgery | Current | Accepting new patients |
| University Surgeons, Inc. | Surgery | Current | Accepting new patients |
Locations
7630 Solutions Ctr
Chicago, IL 60677
3832 Solutions Ctr
Chicago, IL 60677
1801 Senate Blvd
Ste 635
Indianapolis, IN 46202
Phone (317) 923-7211
1701 N Senate Ave
Indianapolis, IN 46202
Phone (317) 929-8447
1701 Senate Blvd
Indianapolis, IN 46202
Phone (317) 612-2754
250 N Shadeland Ave
Ste 130
Indianapolis, IN 46219
Phone (317) 962-4836
550 University Blvd
Indianapolis, IN 46202
Phone (217) 274-5000
250 N Shadeland Ave
Indianapolis, IN 46219
Phone (317) 948-9174
221 N Celia Ave
Muncie, IN 47303
Phone (765) 747-3141
2401 W University Ave
Muncie, IN 47303
Phone (765) 747-3111
Interoperability endpoints
- pjenkins1@direct.iuhealth.org
Organizations & group practices 3
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.
-
- General Practice Physician
- Indianapolis, IN
- NPI 1326893777
-
- Surgery Physician
- Indianapolis, IN
- NPI 1316966229
-
- Family Medicine Physician
- Muncie, IN
- NPI 1235455544
Surgery
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Indianapolis, IN
- NPI 1144266024
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167868800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1663027200000",
"number": "1083761019",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "250 N SHADELAND AVE",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462194959"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1701 N SENATE BLVD",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462021239",
"telephone_number": "317-630-7582",
"fax_number": "317-630-7694"
}
],
"practiceLocations": [
{
"address_1": "1801 N Senate Blvd.",
"address_2": "Suite 635",
"address_purpose": "LOCATION",
"city": "Indianapolis",
"state": "IN",
"postal_code": "462021239",
"country_code": "US",
"telephone_number": "317-963-1400",
"fax_number": "317-962-2595",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "2401 W University Ave",
"address_purpose": "LOCATION",
"city": "Muncie",
"state": "IN",
"postal_code": "473033428",
"country_code": "US",
"telephone_number": "765-289-6381",
"fax_number": "765-448-7646",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "JENKINS",
"first_name": "PETER",
"middle_name": "C",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-04",
"last_updated": "2022-09-13",
"certification_date": "2022-09-13",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "MI",
"license": "4301101564",
"primary": false
},
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "PA",
"license": "MT185869",
"primary": false
},
{
"code": "2086S0102X",
"taxonomy_group": "",
"desc": "Surgery, Surgical Critical Care",
"state": "IN",
"license": "01074216A",
"primary": false
},
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "IN",
"license": "01074216A",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "201233600",
"state": "IN"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "pjenkins1@direct.iuhealth.org",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "1801 N Senate Blvd.",
"address_2": "Suite 635",
"city": "Indianapolis",
"state": "IN",
"country_code": "US",
"postal_code": "462021239",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "pjenkins1@direct.iuhealth.org",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "2401 W University Ave",
"city": "Muncie",
"state": "IN",
"country_code": "US",
"postal_code": "473033428",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Indianapolis, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2022; 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.