Individual provider Active NPI

Perinjit K Niehaus, PA-C

  • Surgical Physician Assistant
  • Bloomington, IN
National Provider Identifier
1093170557
Registry record updated Aug 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
10001960A Issued in IN
Practice address
2605 E Creeks Edge Dr
Bloomington, IN 47401-8368
Phone
(812) 333-2663
Fax
(812) 676-4131
NPI assigned
Dec 28, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 10001960A IN
Surgical Physician Assistant 363AS0400X 10001960A IN Primary

Addresses

Primary practice location

2605 E Creeks Edge Dr
Bloomington, IN 47401-8368

Mailing address

PO Box 1329
Bloomington, IN 47402-1329

Other practice location 1

720 Eskenazi Ave
Indianapolis, IN 46202-5166
Phone (317) 944-7728

Other practice location 2

545 Barnhill Dr EH 215
Indianapolis, IN 46202-5112
Phone (317) 948-0944

Other practice location 3

1701 N Senate Blvd
Indianapolis, IN 46202-1239
Phone (317) 962-3256

Other practice location 4

1801 N Senate Blvd MPC2 #3300
Indianapolis, IN 46202
Phone (317) 948-0944

Other identifiers 5

IdentifierTypeStateIssuer
090540385OtherINMEDICARE PTAN
264430390OtherINMEDICARE PTAN
074790025OtherINMEDICARE PTAN
300005603MedicaidIN
Q00295359OtherINRAILROAD PTAN

Other names 1

  • Perinjit K Bachra Other name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address PBACHRA1@direct.iuhealth.org

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
I20160215000969 IN Practitioner - Physician Assistant 7618271420 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Iu Health Medical Group LLCGroup PAC ID 9638617913, 4,382 clinicians

Practice addresses (Care Compare)

1701 N Senate Blvd
Indianapolis, IN 46202-1239
Phone (888) 484-3258

2605 E Creeks Edge Dr
Bloomington, IN 47401-8368
Phone (888) 484-3258

707 W 2ND St
Bloomington, IN 47403-2209
Phone (888) 484-3258

719 W 2ND St
Bloomington, IN 47403-2209
Phone (888) 484-3258

727 W 2ND St
Bloomington, IN 47403-2209
Phone (888) 484-3258

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Indiana University Health Southern Indiana Physicians LLC CurrentSince Nov 5, 2018 Accepting new patients
Indiana University Health Southern Indiana Physicians, LLC CurrentSince Nov 5, 2018 Accepting new patients
University Medical Diagnostic Associates, Inc. Past Accepting new patients

Locations

727 W 2nd St
Bloomington, IN 47403
Phone (812) 353-3450

2605 E Creeks Edge Dr
Bloomington, IN 47401
Phone (812) 333-2663

250 N Shadeland Ave
Indianapolis, IN 46219
Phone (317) 948-9174

720 Eskenazi Ave
Indianapolis, IN 46202
Phone (317) 880-0000

1701 Senate Blvd
Indianapolis, IN 46202
Phone (317) 612-2754

1801 N Senate Blvd
Ste 3300
Indianapolis, IN 46202
Phone (317) 948-0944

Interoperability endpoints

  • Direct secure messaging: pbachra1@direct.iuhealth.org

Organizations & group practices 6

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 3

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": "1451260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691366400000",
    "number": "1093170557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1329",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474021329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2605 E CREEKS EDGE DR",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474018368",
            "telephone_number": "812-333-2663",
            "fax_number": "812-676-4131"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "720 Eskenazi Ave",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462025166",
            "country_code": "US",
            "telephone_number": "317-944-7728",
            "fax_number": "317-274-2940",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "545 Barnhill Dr EH 215",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462025112",
            "country_code": "US",
            "telephone_number": "317-948-0944",
            "fax_number": "317-274-2940",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1701 N Senate Blvd",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462021239",
            "country_code": "US",
            "telephone_number": "317-962-3256",
            "fax_number": "271-274-2940",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1801 N Senate Blvd MPC2 #3300",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "46202",
            "country_code": "US",
            "telephone_number": "317-948-0944",
            "fax_number": "317-274-2940",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NIEHAUS",
        "first_name": "PERINJIT",
        "middle_name": "K",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-12-28",
        "last_updated": "2023-08-07",
        "certification_date": "2023-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "IN",
            "license": "10001960A",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "IN",
            "license": "10001960A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "090540385",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "264430390",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "074790025",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300005603",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD PTAN",
            "identifier": "Q00295359",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "PBACHRA1@direct.iuhealth.org",
            "affiliation": "N",
            "address_1": "2605 E Creeks Edge Dr",
            "city": "Bloomington",
            "state": "IN",
            "country_code": "US",
            "postal_code": "474018368",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "PERINJIT",
            "last_name": "BACHRA",
            "middle_name": "K",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Bloomington, IN

Sources for this page

Verify at the official NPI Registry.