Individual provider Active NPI

Jessica J Poliskie, M.D.

  • Family Medicine Physician
  • Noblesville, IN
National Provider Identifier
1285900092
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
01075392A Issued in IN
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

Updated by the provider on Nov 27, 2023

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 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

IdentifierTypeStateIssuer
P01599192OtherINRR MEDICARE
201099650MedicaidIN

Other names 1

  • Jessica J Donaldson Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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 IncGroup PAC ID 1759416662, 1,569 clinicians

Practice addresses (Care Compare)

9669 E 146TH St
Suite 250
Noblesville, IN 46060-5006
Phone (317) 621-4657

Hospital & facility affiliations

  • Community Hospital North Hospital, Indianapolis, IN, CCN 150169
  • Riverview Health Hospital, Noblesville, IN, CCN 150059
  • Community Hospital of Anderson and Madison County Hospital, Anderson, IN, CCN 150113
  • Community Hospital East Hospital, Indianapolis, IN, CCN 150074

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01075392AINMDFamily Medicine Physician
11016690AINMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Community Physicians of Indiana Inc CurrentSince Sep 1, 2015 Accepting new patients
Community Physicians of Indiana Inc Family Medicine CurrentSince Sep 1, 2015 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

  • Direct secure messaging: 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.

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": "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

Verify at the official NPI Registry.