Jacob M Capito, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

01077807A Issued in IN

Practice address

1701 N Senate Blvd
Indianapolis, IN 46202-1239

Phone

(317) 962-5975

NPI assigned

Jun 11, 2015

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Emergency Professionals of Indiana, P.C.

  • Emergency Medicine Physician
  • Fort Wayne, IN
  • NPI 1013951219
  Medicare reassignment NPD
• Indiana University Health Care Associates, Inc

  • General Practice Physician
  • Indianapolis, IN
  • NPI 1902032832
  Medicare reassignment NPD
• Innovative Hospital Care, LLC

  • Hospitalist Physician
  • Fort Wayne, IN
  • NPI 1922374172
  NPD (past)
• University Medical Diagnostic Associates, Inc.

  • Internal Medicine Physician
  • Indianapolis, IN
  • NPI 1861441537
  NPD (past)

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

{
    "created_epoch": "1433980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705363200000",
    "number": "1124409578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 N SHADELAND AVE",
            "address_2": "SUITE 130 - PROVIDER ENROLLMENT",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462194959",
            "telephone_number": "317-962-5975",
            "fax_number": "317-962-4343"
        },
        {
            "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": "317-962-5975"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAPITO",
        "first_name": "JACOB",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-11",
        "last_updated": "2024-01-16",
        "certification_date": "2024-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IN",
            "license": "01077807A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0334029",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shelia Rosechell Caperton
• Daniel P Capes, MD
• Oriana Reis Capin, DDS
• Capital Care LLC
• Capital City Family Education Services
• Capitol City Residential Health Care LLC
• Capitol Street Surgery Center LLC
• Courtney Caplinger
• Melanie Weinstein Capobianco, MD
• Emma Noelle Cappella

• Emergency Medicine Physician in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Emergency Medicine Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.