Individual provider Active NPI

Jennifer L Tobin, PA

  • Physician Assistant
  • Fort Wayne, IN
National Provider Identifier
1184616179
Registry record updated Nov 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
10000730A Issued in IN
Practice address
5050 N Clinton St
Fort Wayne, IN 46825
Phone
(260) 484-8551
Fax
(260) 482-5060
NPI assigned
Aug 17, 2005
Last updated
Nov 15, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 50.003806 OH
Physician Assistant 363A00000X 10000730A IN Primary

Addresses

Primary practice location

5050 N Clinton St
Fort Wayne, IN 46825

Mailing address

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

Other practice location 1

1003 Bellefontaine Ave
Suite 125
Lima, OH 45804-2868
Phone (419) 998-8207

Other practice location 2

7920 W Jefferson Blvd
Fort Wayne, IN 46804-4168
Phone (260) 484-8551

Other practice location 3

11136 Parkview Circle Dr
Fort Wayne, IN 46845-1730
Phone (260) 484-8551

Other practice location 4

1500 Provident Dr Ste B
Warsaw, IN 46580-3297
Phone (574) 269-8301

Other practice location 5

3946 Ice Way
Fort Wayne, IN 46805-1018
Phone (260) 266-4007

Other practice location 6

11143 Parkview Plaza Dr Ste 100
Fort Wayne, IN 46845-1728
Phone (260) 266-7400

Other names 1

  • Jennifer L Purdy Former name

Electronic endpoints 3

TypeEndpointUseAffiliation
FHIR URL https://epicprod-mobile.parkview.com/FHIR/api/FHIR/DSTU2/
Direct Messaging Address jtobin12086@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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050114000742 IN Practitioner - Physician Assistant 6901855089 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Parkview Health System IncGroup PAC ID 2163336967, 1,350 clinicians
Orthopaedics Northeast PCGroup PAC ID 9234024878, 80 clinicians

Practice addresses (Care Compare)

2708 Guilford St
Huntington, IN 46750-9701
Phone (260) 355-3900

3946 Ice Way
PPG Therapy Services
Fort Wayne, IN 46805-1018
Phone (260) 266-7400

5050 N Clinton St
Fort Wayne, IN 46825-5886
Phone (260) 484-8551

5052 N Clinton St
Fort Wayne, IN 46825-5822

512 N Professional Way
Kendallville, IN 46755-2927
Phone (260) 347-8556

Hospital & facility affiliations

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

Merit-based Incentive Payment System (MIPS)

Final score
87.82 of 100Reported as group
Quality
85.67
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
10000730AINMDPhysician Assistant
50.003806OHMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Orthopaedics Northeast PC CurrentSince Sep 29, 2004 Accepting new patients
Parkview Health System Inc CurrentSince Dec 1, 2020 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

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

11130 Parkview Circle Dr
Fort Wayne, IN 46845
Phone (260) 266-6221

11136 Parkview Circle Dr
Fort Wayne, IN 46845

11143 Parkview Plaza Dr
Ste 100
Fort Wayne, IN 46845
Phone (260) 266-7400

5050 N Clinton St
Fort Wayne, IN 46825
Phone (219) 484-8551

5052 N Clinton St
Fort Wayne, IN 46825
Phone (260) 408-2203

7920 W Jefferson Blvd
Fort Wayne, IN 46804
Phone (260) 432-2668

512 Professional Way
Kendallville, IN 46755
Phone (260) 347-8556

1500 Provident Dr
Ste B
Warsaw, IN 46580
Phone (574) 269-8301

Interoperability endpoints

  • Direct secure messaging: jtobin12086@direct.parkviewexchange.com

Organizations & group practices 4

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 3

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": "1124236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668470400000",
    "number": "1184616179",
    "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": "5050 N CLINTON ST",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "46825",
            "telephone_number": "260-484-8551",
            "fax_number": "260-482-5060"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1003 Bellefontaine Ave",
            "address_2": "Suite 125",
            "address_purpose": "LOCATION",
            "city": "Lima",
            "state": "OH",
            "postal_code": "458042868",
            "country_code": "US",
            "telephone_number": "419-998-8207",
            "fax_number": "419-998-8216",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7920 W Jefferson Blvd",
            "address_purpose": "LOCATION",
            "city": "Fort Wayne",
            "state": "IN",
            "postal_code": "468044168",
            "country_code": "US",
            "telephone_number": "260-484-8551",
            "fax_number": "260-482-5060",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11136 Parkview Circle Dr",
            "address_purpose": "LOCATION",
            "city": "Fort Wayne",
            "state": "IN",
            "postal_code": "468451730",
            "country_code": "US",
            "telephone_number": "260-484-8551",
            "fax_number": "260-482-5060",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1500 Provident Dr Ste B",
            "address_purpose": "LOCATION",
            "city": "Warsaw",
            "state": "IN",
            "postal_code": "465803297",
            "country_code": "US",
            "telephone_number": "574-269-8301",
            "fax_number": "574-269-8302",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3946 Ice Way",
            "address_purpose": "LOCATION",
            "city": "Fort Wayne",
            "state": "IN",
            "postal_code": "468051018",
            "country_code": "US",
            "telephone_number": "260-266-4007",
            "fax_number": "260-266-4008",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11143 Parkview Plaza Dr Ste 100",
            "address_purpose": "LOCATION",
            "city": "Fort Wayne",
            "state": "IN",
            "postal_code": "468451728",
            "country_code": "US",
            "telephone_number": "260-266-7400",
            "fax_number": "260-266-7439",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TOBIN",
        "first_name": "JENNIFER",
        "middle_name": "L",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-17",
        "last_updated": "2022-11-15",
        "certification_date": "2022-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50.003806",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IN",
            "license": "10000730A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicprod-mobile.parkview.com/FHIR/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "3946 Ice Way",
            "city": "Fort Wayne",
            "state": "IN",
            "country_code": "US",
            "postal_code": "468051018",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jtobin12086@Direct.Parkviewexchange.com",
            "affiliation": "N",
            "address_1": "3946 Ice Way",
            "city": "Fort Wayne",
            "state": "IN",
            "country_code": "US",
            "postal_code": "468051018",
            "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": "3946 Ice Way",
            "city": "Fort Wayne",
            "state": "IN",
            "country_code": "US",
            "postal_code": "468051018",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "PURDY",
            "middle_name": "L",
            "credential": "PA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fort Wayne, IN

Sources for this page

Verify at the official NPI Registry.