Jennie S. Kho-Duffin, M.D.

Primary specialty

Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X

License

01046947A Issued in IN

Practice address

10291 N Meridian St Ste 100
Indianapolis, IN 46290-1000

Phone

(317) 874-1254

NPI assigned

Sep 7, 2006

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 6

Electronic endpoints 1

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Pathology

Education

Indiana University School of Medicine, 1992

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

DCL Pathology LLCGroup PAC ID 1850564675, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jennie.khoduffin@ogi.gwaydirect.com
• Direct secure messaging: jennie.khoduffin@oig.gwaydirect.com

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.

• DCL Pathology LLC

  • Anatomic Pathology & Clinical Pathology Physician
  • Indianapolis, IN
  • NPI 1063771012

  Cytopathology

  Medicare reassignment Care Compare group NPD
• Seven Hills OB-GYN Associates LLC

  • Obstetrics & Gynecology Physician
  • Carmel, IN
  • NPI 1396350187

  Anatomic Pathology & Clinical Pathology

  Medicare reassignment NPD
• DCL Pathology LLC

  • Clinical Medical Laboratory
  • Carmel, IN
  • NPI 1922386325
  NPD
• Seven Hills OB-GYN Associates, LLC

  • Obstetrics & Gynecology Physician
  • Indianapolis, IN
  • NPI 1780312975
  NPD
• DCL Medical Laboratories LLC

  • Clinical Medical Laboratory
  • Indianapolis, IN
  • NPI 1316112337
  NPD (past)
• DCL Laboratories LLC

  • Clinical Medical Laboratory
  • Collinsville, IL
  • NPI 1679887947
  NPD (past)

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

{
    "created_epoch": "1157587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651795200000",
    "number": "1093818445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9550 ZIONSVILLE RD",
            "address_2": "SUITE #200",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462681065",
            "telephone_number": "317-872-0116",
            "fax_number": "317-874-1440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10291 N MERIDIAN ST STE 100",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462901000",
            "telephone_number": "317-874-1254"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHO-DUFFIN",
        "first_name": "JENNIE",
        "middle_name": "S.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-07",
        "last_updated": "2022-05-06",
        "certification_date": "2022-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZC0500X",
            "taxonomy_group": "",
            "desc": "Pathology, Cytopathology",
            "state": "IN",
            "license": "01046947A",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "IN",
            "license": "01046947A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIANA COMPREHENSIVE",
            "identifier": "351609041",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CARESOURCE RBMC",
            "identifier": "200193120",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7118072",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BLUE SHIELD",
            "identifier": "112178",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200193120",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MERCY HEALTH PLAN",
            "identifier": "G83829",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jennie.khoDuffin@oig.gwaydirect.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "11405 Pennsylvania St Ste 260",
            "city": "Carmel",
            "state": "IN",
            "country_code": "US",
            "postal_code": "460327440",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Rajan Suresh Kheradiya, M.D.
• Steven V Kheyfets, MD
• Esther Khiangte
• Rajnish Khillan, MD
• Taniya Salim Khimani, MD
• Abel N Kho
• David Abhishek Khosa, PT
• Michael M Khouli, MD
• Matthew Khouzam
• Nouredean Khrisat, DO

• Anatomic Pathology & Clinical Pathology Physician in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Anatomic Pathology & Clinical Pathology Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 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.

Verify at the official NPI Registry.