Daryl Kinshasa Jenkins, D.P.M.

Primary specialty

PodiatristTaxonomy code 213E00000X

License

07000978A Issued in IN

Practice address

775 Waukegan Rd
Suite 200
Deerfield, IL 60015-4342

Phone

(800) 317-0711

Fax

(800) 434-7113

NPI assigned

Dec 13, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in IN, KY2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Podiatry

Education

Kent State University College of Podiatric Medicine, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

360Care Services of Kentucky LLCGroup PAC ID 9931587888, 17 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: daryl.jenkins.p1@direct.360care.nextgenshare.com
• Direct secure messaging: daryl.jenkins.p4@direct.360care.nextgenshare.com
• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

• 360Care Services of Kentucky LLC

  • Social Worker
  • Louisville, KY
  • NPI 1669113023

  Podiatrist

  Medicare reassignment Care Compare group NPD
• Back Office Management Services LLC

  • Podiatrist
  • Berea, KY
  • NPI 1336652585
  Medicare reassignment NPD
• Michael S. Miller DO, Facos, CWS, PC

  • Surgery Physician
  • Indianapolis, IN
  • NPI 1316072242
  Medicare reassignment NPD
• Onhealthcare, LLC

  • Optometrist
  • Indianapolis, IN
  • NPI 1417220369
  Medicare reassignment NPD
• Podiatry Company LLC

  • Podiatrist
  • Cambridge, MD
  • NPI 1457931610

  KY

  Medicare reassignment NPD
• 360Care Services of Kentucky LLC

  • Nurse Practitioner
  • Louisville, KY
  • NPI 1174394852
  NPD
• Midwest Mobile Care Inc

  • Optometrist
  • Franklin, IN
  • NPI 1942432422
  NPD
• Onhealthcare LLC

  • Social Worker
  • Indianapolis, IN
  • NPI 1114681681
  NPD
• Onhealthcare LLC

  • Podiatrist
  • Indianapolis, IN
  • NPI 1952677353
  NPD
• Phase Two Podiatry PC

  • Podiatrist
  • Hewlett, NY
  • NPI 1821333063
  NPD
• 360Care Services of Kentucky LLC

  • Podiatrist
  • Louisville, KY
  • NPI 1477324150
  NPD (past)
• Hearmax, PLLC

  • Audiologist
  • Louisville, KY
  • NPI 1932248333
  NPD (past)

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

{
    "created_epoch": "1134432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210291200000",
    "number": "1245215318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9414 MEADOW VALLEY LN",
            "address_2": "# 104",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402913954",
            "telephone_number": "502-327-8988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "775 WAUKEGAN RD",
            "address_2": "SUITE 200",
            "city": "DEERFIELD",
            "state": "IL",
            "postal_code": "600154342",
            "telephone_number": "800-317-0711",
            "fax_number": "800-434-7113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENKINS",
        "first_name": "DARYL",
        "middle_name": "KINSHASA",
        "name_prefix": "Dr.",
        "credential": "D.P.M.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-12-13",
        "last_updated": "2008-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "IN",
            "license": "07000978A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "000000333791",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200256110",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gabrielle Marie Javier
• JB Medical Inc
• Jeanne Yakin LTD
• Jeff Foreman, M.D., LLC
• Jen Underwood LCSW and Associates, Inc.
• Jennifer Gelb Harris OT LLC
• Jennifer Irene Kirchens DPM PC
• Jason John Jerisha, DPM
• Jerome G Zwierzycki MD SC
• JLM Counseling LTD

• Podiatrist in Deerfield, IL
• Providers in Deerfield, IL by specialty
• Podiatrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2008; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.