Individual provider Active NPI

Jennifer N Sitzman, NP

  • Family Nurse Practitioner
  • Evansville, IN
National Provider Identifier
1134462070
Registry record updated Apr 5, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
71004395A Issued in IN
Practice address
415 W Columbia St
Ste 110
Evansville, IN 47710-1656
Phone
(812) 450-3363
Fax
(812) 450-3071
NPI assigned
Mar 28, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 71004395A IN Primary

Addresses

Primary practice location

415 W Columbia St
Ste 110
Evansville, IN 47710-1656

Mailing address

PO Box 3407
Evansville, IN 47733-3407
Phone (812) 450-3363

Other identifiers 1

IdentifierTypeStateIssuer
200188920MedicaidIN

Other names 1

  • Jennifer N Provence Former name

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
I20130904000107 IN Practitioner - Nurse Practitioner 5294978631 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Deaconess Hospital, Inc.Group PAC ID 9032021431, 410 clinicians

Practice addresses (Care Compare)

415 W Columbia St
Evansville, IN 47710-1656

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.17 of 100Reported as group
Quality
82.57
Promoting interoperability
100
Improvement activities
40
Cost
71.91

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Deaconess Hospital, Inc Family CurrentSince May 1, 2013 Accepting new patients
Deaconess Hospital, Inc Family Current Accepting new patients
Deaconess Hospital Inc CurrentSince May 1, 2013 Accepting new patients

Locations

415 W Columbia St
Ste 100
Evansville, IN 47710
Phone (812) 450-3363

415 W Columbia St
#110
Evansville, IN 47710
Phone (812) 450-3363

4600 W Lloyd Expy
Evansville, IN 47712
Phone (812) 450-6311

415 W Columbia St
Ste 110
Evansville, IN 47710
Phone (812) 450-3363

415 W Columbia St
#100
Evansville, IN 47710
Phone (812) 450-6200

Interoperability endpoints

  • Direct secure messaging: jsitzman14801@direct.deaconess.com

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.

Hospital & facility affiliations 2

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": "1364428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491350400000",
    "number": "1134462070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3407",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477333407",
            "telephone_number": "812-450-3363",
            "fax_number": "812-450-3071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 W COLUMBIA ST",
            "address_2": "STE 110",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477101656",
            "telephone_number": "812-450-3363",
            "fax_number": "812-450-3071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SITZMAN",
        "first_name": "JENNIFER",
        "middle_name": "N",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-03-28",
        "last_updated": "2017-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71004395A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200188920",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "PROVENCE",
            "middle_name": "N",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Evansville, IN

Sources for this page

Verify at the official NPI Registry.