Individual provider Active NPI

Jordan Geroski, DO

  • Sports Medicine (Family Medicine) Physician
  • Angola, IN
National Provider Identifier
1265962633
Registry record updated Feb 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X
License
02006037A Issued in IN
Practice address
1381 N Wayne St
Angola, IN 46703-2348
Phone
(260) 665-8222
NPI assigned
Jun 18, 2017
Last updated
Feb 3, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 02006037A IN
Sports Medicine (Family Medicine) Physician 207QS0010X 02006037A IN Primary

Addresses

Primary practice location

1381 N Wayne St
Angola, IN 46703-2348

Mailing address

416 E Maumee St
Angola, IN 46703-2015
Phone (260) 667-5131

Other identifiers 2

IdentifierTypeStateIssuer
11019303AOtherINSTATE LICENSE
300004615MedicaidIN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jordan.geroski@directsjrmc.mhin.net Direct

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210629002571 IN Practitioner - Family PracticePractitioner - Sports Medicine 1153690037 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Sports Medicine
Education
Ohio University, College of Osteopathic Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cameron Memorial Community Hospital IncGroup PAC ID 9234020835, shared by 8 NPIs, 83 clinicians

Practice addresses (Care Compare)

1381 N Wayne St
Angola, IN 46703-2348
Phone (260) 665-8222

611 E Douglas Rd
Suite 406 Family Medicine Faculty Physicia
Mishawaka, IN 46545-1468
Phone (574) 335-6580

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
02006037AINMDSports Medicine (Family Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Saint Joseph Regional Medical Center-South Bend Campus, Inc Current Accepting new patients
Saint Joseph Regional Medical Center, Inc. Current Accepting new patients
Cameron Memorial Community Hospital, Inc. CurrentSince Nov 12, 2025 Accepting new patients
Saint Joseph Regional Medical Center- Plymouth Campus Inc Family Medicine CurrentSince Jun 28, 2021 Accepting new patients
Saint Joseph Regional Medical Center-South Bend Campus, Inc CurrentSince Jun 28, 2021 Accepting new patients
Cameron Memorial Community Hospital, Inc Family Medicine CurrentSince Nov 12, 2025 Accepting new patients
Saint Joseph Regional Medical Center- Plymouth Campus Inc CurrentSince Jun 28, 2021 Accepting new patients
Saint Joseph Regional Medical Center-South Bend Campus, Inc. CurrentSince Jun 28, 2021 Accepting new patients
Saint Joseph Regional Medical Center-South Bend Campus, Inc. Family Medicine Past Accepting new patients

Locations

1381 N Wayne St
Angola, IN 46703
Phone (219) 481-4700

306 E Maumee St
Angola, IN 46703
Phone (260) 667-5335

416 E Maumee St
Angola, IN 46703
Phone (260) 665-2141

3421 Cassopolis St
Elkhart, IN 46514
Phone (574) 335-8180

5215 Holy Cross Pkwy
Mishawaka, IN 46545
Phone (574) 335-2443

60101 Bodnar Blvd
Ste 100B
Mishawaka, IN 46544
Phone (574) 335-8500

611 E Douglas Rd
Ste 137
Mishawaka, IN 46545
Phone (574) 335-6214

611 E Douglas Rd
Ste 309
Mishawaka, IN 46545
Phone (574) 335-6232

611 E Douglas Rd
Ste 406
Mishawaka, IN 46545
Phone (574) 335-6500

611 E Douglas Rd
Ste 407
Mishawaka, IN 46545
Phone (574) 335-6500

1915 Lake Ave
Plymouth, IN 46563
Phone (219) 936-3181

1919 Lake Ave
Ste 102B
Plymouth, IN 46563
Phone (574) 335-6214

510 W Adams St
Ste 150
Plymouth, IN 46563
Phone (574) 335-3987

707 Cedar St
Ste 200
South Bend, IN 46617
Phone (574) 237-1328

616 E 13th St
Winamac, IN 46996
Phone (574) 946-2100

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/5ac0007d-0893-4627-b11f-857c06d27ab1/
  • FHIR API: https://fhir-myrecord.cerner.com/r4/781d290a-0fb7-4574-b825-dd38fe495caa/
  • Direct secure messaging: jgeroski1158672@direct.trinity-health.org

Organizations & group practices 9

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": "1497744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770076800000",
    "number": "1265962633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "416 E MAUMEE ST",
            "city": "ANGOLA",
            "state": "IN",
            "postal_code": "467032015",
            "telephone_number": "260-667-5131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1381 N WAYNE ST",
            "city": "ANGOLA",
            "state": "IN",
            "postal_code": "467032348",
            "telephone_number": "260-665-8222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GEROSKI",
        "first_name": "JORDAN",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-18",
        "last_updated": "2026-02-03",
        "certification_date": "2026-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "02006037A",
            "primary": false
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "IN",
            "license": "02006037A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "11019303A",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300004615",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jordan.geroski@directsjrmc.mhin.net",
            "affiliation": "N",
            "endpointDescription": "SJRMC MHIN Direct Email Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "611 E Douglas Rd Ste 137",
            "city": "Mishawaka",
            "state": "IN",
            "country_code": "US",
            "postal_code": "465451464",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Angola, IN

Sources for this page

Verify at the official NPI Registry.