Individual provider Active NPI

Jennifer A. Pallone, D.O.

  • Psychiatry Physician
  • Merrillville, IN
National Provider Identifier
1295888923
Registry record updated Jun 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
02001957A Issued in IN
Practice address
521 E 86TH Ave Ste Z
Merrillville, IN 46410-6236
Phone
(219) 769-0777
Fax
(219) 755-0608
NPI assigned
Jan 18, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2021

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 62273 CT
Neurology Physician 2084N0400X 036084506 IL
Neurology Physician 2084N0400X 297065 NY
Psychiatry Physician 2084P0800X 02001957A IN Primary

Addresses

Primary practice location

521 E 86TH Ave Ste Z
Merrillville, IN 46410-6236

Mailing address

521 E 86TH Ave Ste Z
Merrillville, IN 46410-6236
Phone (219) 769-0777

Other identifiers 4

IdentifierTypeStateIssuer
F400160547OtherILMEDICARE PTAN (INDIVIDUAL)
201614OtherILMEDICARE PTAN (GROUP)
84101OtherANTHEM
036084506OtherILMEDICAID

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
I20101215001162 IN Practitioner - Neurology 2264620376 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
At Still University of Health Sciences, College of Osteo Med, Kirksville, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Select Rehabilitation, LLCGroup PAC ID 9032020490, 1,935 clinicians
The Methodist Hospitals IncGroup PAC ID 9638063894, 131 clinicians

Practice addresses (Care Compare)

2600 Compass Rd
Glenview, IL 60026-8001

521 E 86TH Ave
Suite Z
Merrillville, IN 46410-6236
Phone (219) 769-0777

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
78.64 of 100Reported as group
Quality
56.64
Promoting interoperability
73
Improvement activities
40
Cost
76.72

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
043040NYMDPharmacist
62273CTMDNeurology Physician
036084506ILMDNeurology Physician
297065NYMDNeurology Physician
02001957AINMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Methodist Hospitals, Inc Neurology CurrentSince Jan 1, 2024 Accepting new patients
Centers for Neurological Diseases, PC Neurology CurrentSince Dec 1, 2020 Accepting new patients
The Methodist Hospitals, Inc Current Accepting new patients
Gibson Community Hospital Association Past Accepting new patients
Health Quest Medical Practice, PC Past Accepting new patients

Locations

27350 Network Pl
Chicago, IL 60673

10260 191st St
Ste 100
Mokena, IL 60448
Phone (708) 425-1907

8701 Broadway
Merrillville, IN 46410
Phone (219) 738-4926

200 E 89th Ave
Merrillville, IN 46410
Phone (219) 738-4926

521 E 86th Ave
Ste Z
Merrillville, IN 46410
Phone (219) 769-0777

521 E 86th Ave
Merrillville, IN 46410
Phone (219) 323-3311

Organizations & group practices 6

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 5

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": "1169078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623024000000",
    "number": "1295888923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "521 E 86TH AVE STE Z",
            "city": "MERRILLVILLE",
            "state": "IN",
            "postal_code": "464106236",
            "telephone_number": "219-769-0777",
            "fax_number": "219-755-0608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "521 E 86TH AVE STE Z",
            "city": "MERRILLVILLE",
            "state": "IN",
            "postal_code": "464106236",
            "telephone_number": "219-769-0777",
            "fax_number": "219-755-0608"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALLONE",
        "first_name": "JENNIFER",
        "middle_name": "A.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-18",
        "last_updated": "2021-06-07",
        "certification_date": "2021-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "CT",
            "license": "62273",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "IL",
            "license": "036084506",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NY",
            "license": "297065",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IN",
            "license": "02001957A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN (INDIVIDUAL)",
            "identifier": "F400160547",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN (GROUP)",
            "identifier": "201614",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "84101",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID",
            "identifier": "036084506",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Merrillville, IN

Sources for this page

Verify at the official NPI Registry.