Active NPI
Jessica J Poliskie, M.D.
- Family Medicine Physician
- Noblesville, IN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 01075392A
- Practice address
- 9669 E 146TH St
Suite 250
Noblesville, IN 46060-5005 - Phone
- (317) 621-9926
- Fax
- (317) 621-9676
- NPI assigned
- Mar 26, 2012
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 11016690A | IN | |
| Family Medicine Physician | 207Q00000X | 01075392A | IN | Primary |
Addresses
Primary practice location
9669 E 146TH St
Suite 250
Noblesville, IN 46060-5005
Mailing address
6626 E 75TH St
Suite 500
Indianapolis, IN 46250-2805
Phone (317) 621-7588
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P01599192 | Other | IN | RR MEDICARE |
| 201099650 | Medicaid | IN |
Other names 1
- Jessica J Donaldson
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | jdonaldson169171@eCommunityDirect.com | Community Physicians of Indiana Inc |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150813010025 | IN | Practitioner - Family Practice | 0749413722 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- Indiana University School of Medicine, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Community Physicians of Indiana Inc
Practice addresses (Care Compare)
9669 E 146TH St
Suite 250
Noblesville, IN 46060-5006
Phone (317) 621-4657
Hospital & facility affiliations
- Community Hospital North
- Riverview Health
- Community Hospital of Anderson and Madison County
- Community Hospital East
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01075392A | IN | MD | Family Medicine Physician |
| 11016690A | IN | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Community Physicians of Indiana Inc | Current | Accepting new patients | |
| Community Physicians of Indiana Inc | Family Medicine | Current | Accepting new patients |
| Major Hospital | Past | Accepting new patients |
Locations
5819 Reliable Pkwy
Chicago, IL 60686
7120 Clearvista Dr
Ste 4000
Indianapolis, IN 46256
Phone (317) 621-7444
6626 E 75th St
Ste 500
Indianapolis, IN 46250
Phone (317) 621-7547
9669 E 146th St
Ste 250
Noblesville, IN 46060
Phone (317) 621-4657
Interoperability endpoints
- jdonaldson169171@ecommunitydirect.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 and National Provider Directory roles.
-
- Family Medicine Physician
- Indianapolis, IN
- NPI 1619105244
Family Medicine, IN
-
- Endocrinology, Diabetes & Metabolism Physician
- Carmel, IN
- NPI 1992396337
-
- General Acute Care Hospital
- Shelbyville, IN
- NPI 1174555692
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Anderson, IN
- NPI 1972500452
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1332720000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1701043200000",
"number": "1285900092",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6626 E 75TH ST",
"address_2": "SUITE 500",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462502805",
"telephone_number": "317-621-7588"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9669 E 146TH ST",
"address_2": "SUITE 250",
"city": "NOBLESVILLE",
"state": "IN",
"postal_code": "460605005",
"telephone_number": "317-621-9926",
"fax_number": "317-621-9676"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POLISKIE",
"first_name": "JESSICA",
"middle_name": "J",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-03-26",
"last_updated": "2023-11-27",
"certification_date": "2020-09-18",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "IN",
"license": "11016690A",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "IN",
"license": "01075392A",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE",
"identifier": "P01599192",
"state": "IN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "201099650",
"state": "IN"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "jdonaldson169171@eCommunityDirect.com",
"affiliation": "Y",
"affiliationName": "Community Physicians of Indiana Inc",
"address_1": "9669 E 146th St",
"address_2": "Suite 250",
"city": "Noblesville",
"state": "IN",
"country_code": "US",
"postal_code": "460605005",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"first_name": "JESSICA",
"last_name": "DONALDSON",
"middle_name": "J",
"credential": "M.D.",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Noblesville, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2023; 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.