Individual provider Active NPI

Juan C Cabrera Jr., MD

  • Geriatric Psychiatry Physician
  • Evansville, IN
National Provider Identifier
1295742377
Registry record updated Jul 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Psychiatry PhysicianTaxonomy code 2084P0805X
License
01038887 Issued in IN
Practice address
101 Plaza East Blvd Ste 303
Evansville, IN 47715-2871
Phone
(812) 473-1307
Fax
(812) 473-1035
NPI assigned
Aug 2, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 15, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Psychiatry Physician 2084P0805X 01038887 IN Primary

Addresses

Primary practice location

101 Plaza East Blvd Ste 303
Evansville, IN 47715-2871

Mailing address

101 Plaza East Blvd Ste 303
Evansville, IN 47715-2871
Phone (812) 479-1511

Other identifiers 1

IdentifierTypeStateIssuer
200002820BMedicaidIN

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
I20040130000070 IN Practitioner - Psychiatry 3971406505 Practice locations: Evansville, IN

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Indiana University School of Medicine, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

101 Plaza E Blvd
Evansville, IN 47715-2871
Phone (812) 479-1511

Hospital & facility affiliations

  • Deaconess Hospital Inc Hospital, Evansville, IN, CCN 150082

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01038887INMDGeriatric Psychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mary Austin Pmhnp LLC PastSince Dec 1, 2019 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: jcabrera278078@direct.deaconess.com

Organizations & group practices 1

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 2

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": "1154476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626307200000",
    "number": "1295742377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 PLAZA EAST BLVD STE 303",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477152871",
            "telephone_number": "812-479-1511",
            "fax_number": "812-473-1035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 PLAZA EAST BLVD STE 303",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477152871",
            "telephone_number": "812-473-1307",
            "fax_number": "812-473-1035"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CABRERA",
        "first_name": "JUAN",
        "middle_name": "C",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-02",
        "last_updated": "2021-07-15",
        "certification_date": "2021-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0805X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Geriatric Psychiatry",
            "state": "IN",
            "license": "01038887",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200002820B",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Evansville, IN

Sources for this page

Verify at the official NPI Registry.