Individual provider Active NPI

Precious M Simataa, FNP-C

  • Family Nurse Practitioner
  • Indianapolis, IN
National Provider Identifier
1326640640
Registry record updated Jan 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
71010937A Issued in IN
Practice address
1400 N Ritter Ave Ste 220
Indianapolis, IN 46219-3046
Phone
(317) 715-5600
Fax
(317) 715-5618
NPI assigned
Nov 11, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 28208316A IN
Family Nurse Practitioner 363LF0000X 71010937A IN Primary

Addresses

Primary practice location

1400 N Ritter Ave Ste 220
Indianapolis, IN 46219-3046

Mailing address

6983 Hillsdale CT
Indianapolis, IN 46250-2054
Phone (317) 849-8350

Other practice location 1

11020 Pendleton Pike
Indianapolis, IN 46236-2817
Phone (317) 806-1140

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address referrals@jwmn.gwaydirect.com Direct

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210402000290 IN Practitioner - Nurse Practitioner 5991112252 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Physicians of Indiana IncGroup PAC ID 1759416662, 1,569 clinicians

Practice addresses (Care Compare)

11020 Pendleton Pike
Indianapolis, IN 46236-2817
Phone (317) 826-3903

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
28208316AINMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Community Physicians of Indiana Inc CurrentSince Feb 1, 2023 Accepting new patients
Community Physicians of Indiana Inc CurrentSince Feb 1, 2023 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

11020 Pendleton Pike
Indianapolis, IN 46236
Phone (317) 806-1140

1400 N Ritter Ave
Ste 220
Indianapolis, IN 46219
Phone (317) 355-1555

Interoperability endpoints

  • Direct secure messaging: psimataa@jwmn.gwaydirect.com
  • Direct secure messaging: psimataa17057@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.

NPI Registry JSON

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

{
    "created_epoch": "1605052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675123200000",
    "number": "1326640640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6983 HILLSDALE CT",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462502054",
            "telephone_number": "317-849-8350",
            "fax_number": "317-576-6311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 N RITTER AVE STE 220",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462193046",
            "telephone_number": "317-715-5600",
            "fax_number": "317-715-5618"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11020 Pendleton Pike",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462362817",
            "country_code": "US",
            "telephone_number": "317-806-1140",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIMATAA",
        "first_name": "PRECIOUS",
        "middle_name": "M",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-11",
        "last_updated": "2023-01-31",
        "certification_date": "2023-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IN",
            "license": "28208316A",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71010937A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "referrals@jwmn.gwaydirect.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1400 N Ritter Ave Ste 220",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "462193046",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.