Individual provider Active NPI

Vimal Jayswal, MD

  • Pediatric Cardiology Physician
  • Fort Wayne, IN
National Provider Identifier
1124250915
Registry record updated Oct 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Cardiology PhysicianTaxonomy code 2080P0202X
License
01079115A Issued in IN
Practice address
11123 Parkview Plaza Dr Ste 200
Fort Wayne, IN 46845-1707
Phone
(260) 425-6100
Fax
(260) 425-6105
NPI assigned
Aug 13, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 10, 2022

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 35.097422 OH
Pediatric Cardiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2080P0202X 01079115 IN
Pediatric Cardiology Physician 2080P0202X 35.097422 OH
Pediatric Cardiology Physician 2080P0202X 01079115A IN Primary

Addresses

Primary practice location

11123 Parkview Plaza Dr Ste 200
Fort Wayne, IN 46845-1707

Mailing address

11109 Parkview Plaza Dr # 117
Fort Wayne, IN 46845-1701

Other identifiers 1

IdentifierTypeStateIssuer
0102438MedicaidOH

Electronic endpoints 3

TypeEndpointUseAffiliation
FHIR URL https://epicprod-mobile.parkview.com/FHIR/api/FHIR/DSTU2/
Direct Messaging Address vjayswal119053@Direct.Parkviewexchange.com
FHIR URL https://epicprod-mobile.parkview.com/FHIR/api/FHIR/R4/

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171017000315 IN Practitioner - Pediatric MedicinePractitioner - Cardiovascular Disease (Cardiology) 6204059918 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
83.53 of 100Reported as group
Quality
70
Promoting interoperability
100
Improvement activities
40
Cost
75.11

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
01079115INMDPediatric Cardiology Physician
35.097422OHMDPediatric Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Parkview Health System Inc Multi-Specialty CurrentSince Nov 1, 2017 Accepting new patients

Locations

817 Trail Ridge Rd
Albion, IN 46701
Phone (260) 373-9590

11109 Parkview Plaza Dr
#117
Fort Wayne, IN 46845
Phone (260) 266-6012

3702 New Vision Dr
Bldg B
Fort Wayne, IN 46845
Phone (260) 266-8210

3926 New Vision Dr
Fort Wayne, IN 46845
Phone (260) 266-8210

11123 Parkview Plaza Dr
Ste 200
Fort Wayne, IN 46845
Phone (260) 425-6100

Interoperability endpoints

  • Direct secure messaging: vjayswal119053@direct.parkviewexchange.com

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1250121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665360000000",
    "number": "1124250915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11109 PARKVIEW PLAZA DR # 117",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468451701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11123 PARKVIEW PLAZA DR STE 200",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468451707",
            "telephone_number": "260-425-6100",
            "fax_number": "260-425-6105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAYSWAL",
        "first_name": "VIMAL",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-08-13",
        "last_updated": "2022-10-10",
        "certification_date": "2022-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OH",
            "license": "35.097422",
            "primary": false
        },
        {
            "code": "2080P0202X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "IN",
            "license": "01079115",
            "primary": false
        },
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "OH",
            "license": "35.097422",
            "primary": false
        },
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "IN",
            "license": "01079115A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0102438",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicprod-mobile.parkview.com/FHIR/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "11123 Parkview Plaza Dr Ste 200",
            "city": "Fort Wayne",
            "state": "IN",
            "country_code": "US",
            "postal_code": "468451707",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "vjayswal119053@Direct.Parkviewexchange.com",
            "affiliation": "N",
            "address_1": "11123 Parkview Plaza Dr Ste 200",
            "city": "Fort Wayne",
            "state": "IN",
            "country_code": "US",
            "postal_code": "468451707",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicprod-mobile.parkview.com/FHIR/api/FHIR/R4/",
            "affiliation": "N",
            "address_1": "11123 Parkview Plaza Dr Ste 200",
            "city": "Fort Wayne",
            "state": "IN",
            "country_code": "US",
            "postal_code": "468451707",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

Verify at the official NPI Registry.