Individual provider Active NPI

Jessica Ann Surma, RN, FNP-C

  • Family Nurse Practitioner
  • Michigan City, IN
National Provider Identifier
1245071646
Registry record updated Sep 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
71015306A Issued in IN
Practice address
601 W Kieffer Rd
Michigan City, IN 46360-9599
Phone
(219) 878-9870
NPI assigned
Jun 3, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 71015306A IN Primary
Nurse Practitioner 363L00000X 71015306A IN

Addresses

Primary practice location

601 W Kieffer Rd
Michigan City, IN 46360-9599

Mailing address

6345 E 250 N
Grovertown, IN 46531-9312
Phone (219) 851-0532

Other practice location 1

7002 W Johnson Rd
LA Porte, IN 46350-8289
Phone (219) 785-8424

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
I20240807004225 IN Practitioner - Nurse Practitioner 5698212637 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Nadeem U Kamran,MD, LLCGroup PAC ID 5092831149, 2 clinicians

Practice addresses (Care Compare)

7002 W Johnson Rd
La Porte, IN 46350-8289
Phone (219) 785-8424

Hospital & facility affiliations

  • Franciscan Health Michigan City Hospital, Michigan City, IN, CCN 150015
  • Northwest Health-la Porte Hospital, La Porte, IN, CCN 150006
  • Northwest Health - Porter Hospital, Valparaiso, IN, CCN 150035

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
71015306AINMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Nadeem U Kamran,MD, LLC CurrentSince Jul 1, 2024 Accepting new patients
The Neuroclinic P C Past Accepting new patients

Locations

101 Beverly Dr
Ste D
Chesterton, IN 46304
Phone (219) 214-2047

7002 W Johnson Rd
La Porte, IN 46350
Phone (219) 325-0604

Organizations & group practices 2

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.

Hospital & facility affiliations 4

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": "1717372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725321600000",
    "number": "1245071646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6345 E 250 N",
            "city": "GROVERTOWN",
            "state": "IN",
            "postal_code": "465319312",
            "telephone_number": "219-851-0532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 W KIEFFER RD",
            "city": "MICHIGAN CITY",
            "state": "IN",
            "postal_code": "463609599",
            "telephone_number": "219-878-9870"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7002 W Johnson Rd",
            "address_purpose": "LOCATION",
            "city": "LA Porte",
            "state": "IN",
            "postal_code": "463508289",
            "country_code": "US",
            "telephone_number": "219-785-8424",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SURMA",
        "first_name": "JESSICA",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "RN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-03",
        "last_updated": "2024-09-03",
        "certification_date": "2024-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71015306A",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IN",
            "license": "71015306A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Michigan City, IN

Sources for this page

Verify at the official NPI Registry.