Active NPI
Joli Jungels Daley, PA
- Physician Assistant
- Fort Wayne, IN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 100004170A
- Practice address
- 3512 Stellhorn Rd
Fort Wayne, IN 46815-4631 - Phone
- (260) 483-9081
- NPI assigned
- Oct 18, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 100004170A | IN | Primary |
Addresses
Primary practice location
3512 Stellhorn Rd
Fort Wayne, IN 46815-4631
Mailing address
PO Box 392552
Pittsburgh, PA 15251-9500
Phone (512) 792-4402
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: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
150 W Market St
Suite 400
Indianapolis, IN 46204-2810
Phone (855) 743-2247
8398 Mississippi St
FL 2
Merrillville, IN 46410-6316
Phone (855) 743-2247
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Science, Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Eventus WH Midwest Care, LLC | Physician Assistant | Current | Accepting new patients |
| Eventus Ecs - Kentucky, PLLC | Current | Accepting new patients |
Locations
3815 River Crossing Pkwy
Ste 100
Indianapolis, IN 46240
Phone (317) 218-3479
150 W Market St
Ste 400
Indianapolis, IN 46204
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 and National Provider Directory roles.
-
- Nurse Practitioner
- Indianapolis, IN
- NPI 1073353496
-
- Adult Medicine Physician
- Merrillville, IN
- NPI 1134146079
-
- Family Medicine Physician
- Columbus, IN
- NPI 1386252757
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Franklin, IN
- NPI 1346248986
-
dba JMH Immediate/Occupation Health
- Occupational Medicine Clinic/Center
- Franklin, IN
- NPI 1679577357
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1697587200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1697587200000",
"number": "1306628870",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 392552",
"city": "PITTSBURGH",
"state": "PA",
"postal_code": "152519500",
"telephone_number": "512-792-4402"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3512 STELLHORN RD",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "468154631",
"telephone_number": "260-483-9081"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JUNGELS DALEY",
"first_name": "JOLI",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-10-18",
"last_updated": "2023-10-18",
"certification_date": "2023-10-18",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "IN",
"license": "100004170A",
"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 Oct 18, 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.