Individual provider Active NPI

Jason R Bickel, DPM

  • Podiatrist
  • Vincennes, IN
National Provider Identifier
1093709750
Registry record updated Apr 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
07001040A Issued in IN
Practice address
202 Broadway St
Vincennes, IN 47591-1228
Phone
(812) 882-3312
Fax
(812) 882-6181
NPI assigned
Sep 8, 2005
Last updated
Apr 6, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 599 TN
Podiatrist 213E00000X 07001040A IN Primary
Foot & Ankle Surgery Podiatrist 213ES0103X 07001040A IN

Addresses

Primary practice location

202 Broadway St
Vincennes, IN 47591-1228

Mailing address

1160 E Saint Clair St
Vincennes, IN 47591-4853
Phone (812) 885-3325

Other practice location 1

328 N 2nd St Ste 205
Vincennes, IN 47591
Phone (812) 882-3312

Other identifiers 3

IdentifierTypeStateIssuer
000000542574OtherILANTHEM
200879590AMedicaidIN
000000542568OtherINANTHEM

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071121000531 IN Practitioner - Podiatry 6901885458 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
College of Podiatric Med and Surgery, Des Moines University, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Healthdrive Podiatry Group PCGroup PAC ID 3375446958, 105 clinicians

Practice addresses (Care Compare)

201 N Illinois St
FL 16
Indianapolis, IN 46204-1904
Phone (888) 964-6681

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of skin lesions1-10
Removal of nail tissue8160
Removal or shaving of skin growth944

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
599TNMDSpecialist
07001040AINMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Healthdrive Podiatry Group, PC Podiatrist CurrentSince Dec 1, 2024 Accepting new patients
Greeneville Orthopaedic Clinic, P.C. Specialist PastSince Mar 1, 2001 Accepting new patients
Vincennes Podiatry Associates, LLC Foot & Ankle Surgery PastSince Nov 12, 2007 Accepting new patients

Locations

100 Crossing Blvd
Ste 300
Framingham, MA 01702
Phone (857) 255-0486

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, 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": "1126137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649203200000",
    "number": "1093709750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1160 E SAINT CLAIR ST",
            "city": "VINCENNES",
            "state": "IN",
            "postal_code": "475914853",
            "telephone_number": "812-885-3325",
            "fax_number": "812-885-8499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 BROADWAY ST",
            "city": "VINCENNES",
            "state": "IN",
            "postal_code": "475911228",
            "telephone_number": "812-882-3312",
            "fax_number": "812-882-6181"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "328 N 2nd St Ste 205",
            "address_purpose": "LOCATION",
            "city": "Vincennes",
            "state": "IN",
            "postal_code": "47591",
            "country_code": "US",
            "telephone_number": "812-882-3312",
            "fax_number": "812-882-6181",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BICKEL",
        "first_name": "JASON",
        "middle_name": "R",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-08",
        "last_updated": "2022-04-06",
        "certification_date": "2022-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "TN",
            "license": "599",
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "IN",
            "license": "07001040A",
            "primary": true
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "IN",
            "license": "07001040A",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000542574",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200879590A",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000542568",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Vincennes, IN

Sources for this page

Verify at the official NPI Registry.