Individual provider Active NPI

Jade Januseski, M.A., CCC-SLP

  • Speech-Language Pathologist
  • Fort Wayne, IN
National Provider Identifier
1295204782
Registry record updated Nov 14, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
22005848A Issued in IN
Practice address
1010 W Washington Center Rd
Fort Wayne, IN 46825-4155
Phone
(260) 489-2552
NPI assigned
Nov 14, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 22005848A IN Primary

Addresses

Primary practice location

1010 W Washington Center Rd
Fort Wayne, IN 46825-4155

Mailing address

1010 W Washington Center Rd
Fort Wayne, IN 46825-4155
Phone (260) 489-2552

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210421001850 IN Practitioner - Qualified Speech Language Pathologist 9436567989 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 2012
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1335 Stranssner Dr
Brentwood, MO 63144-1872

2601 Network Blvd
Suite 102
Frisco, TX 75034-9092

2716 Jacobs Creek Run
Fort Wayne, IN 46825-3194

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
22005848AINMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Empowerme Rehabilitation Illinois, LLC Speech-Language Pathologist CurrentSince Apr 9, 2021 Accepting new patients
Aegis Group Practice LLC Speech-Language Pathologist Current Accepting new patients
Aegis Group Practice LLC Speech-Language Pathologist CurrentSince Feb 7, 2022 Accepting new patients
Aegis Group Practice LLC Speech-Language Pathologist CurrentSince Feb 7, 2022 Accepting new patients
Empowerme Rehabilitation Illinois, LLC Speech-Language Pathologist CurrentSince Apr 9, 2021 Accepting new patients

Locations

4933 Old Greenwood Rd
Fort Smith, AR 72903

3203 E Moores Pike
Bloomington, IN 47401
Phone (812) 269-8220

7900 Rhode Island St
#1504
Merrillville, IN 46410
Phone (219) 649-0625

5865 Sugar Ln
Plainfield, IN 46168
Phone (317) 680-7999

1335 Strassner Dr
Saint Louis, MO 63144
Phone (314) 287-3917

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1542153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542153600000",
    "number": "1295204782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1010 W WASHINGTON CENTER RD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468254155",
            "telephone_number": "260-489-2552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 W WASHINGTON CENTER RD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468254155",
            "telephone_number": "260-489-2552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JANUSESKI",
        "first_name": "JADE",
        "credential": "M.A., CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-14",
        "last_updated": "2018-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IN",
            "license": "22005848A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.