Individual provider Active NPI

Jason Douglas, M.D., M.P.H.

  • Internal Medicine Physician
  • Indianapolis, IN
National Provider Identifier
1346620564
Registry record updated Aug 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
01087704A Issued in IN
Practice address
7150 Clearvista Dr
Indianapolis, IN 46256-1695
Phone
(317) 621-6262
NPI assigned
Jun 3, 2015
Last updated
Aug 19, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 19, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 57.025883 OH
Internal Medicine Physician 207R00000X 01087704A IN Primary

Addresses

Primary practice location

7150 Clearvista Dr
Indianapolis, IN 46256-1695

Mailing address

6626 E 75TH St Ste 500
Indianapolis, IN 46250-2890
Phone (317) 621-7584

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, IN2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20180803002984 OH Practitioner - Internal Medicine 7113275330 Reassigns benefits to 3 organizations
I20220805000691 IN Practitioner - Internal MedicinePractitioner - Hospitalist 7113275330 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Hospitalist
Education
Rush Medical College of Rush University, 2015
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)

7150 Clearvista Dr
Indianapolis, IN 46256-1695
Phone (317) 621-6262

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
57.025883OHMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Community Physicians of Indiana Inc Internal Medicine CurrentSince Aug 1, 2022 Accepting new patients
Hospitalist Medicine Physicians of Ohio, Professional Corporation Internal Medicine CurrentSince Jul 1, 2018 Accepting new patients
Hospitalist Medicine Physicians of Richland County, LTD Internal Medicine CurrentSince Feb 10, 2020 Accepting new patients
Community Physicians of Indiana Inc CurrentSince Aug 1, 2022 Accepting new patients
Usacs Integrated Acute Care Services of Ohio, LLC Internal Medicine CurrentSince Apr 27, 2023 Accepting new patients

Locations

5819 Reliable Pkwy
Chicago, IL 60686

6626 E 75th St
Ste 500
Indianapolis, IN 46250
Phone (317) 621-7547

7150 Clearvista Dr
Indianapolis, IN 46256
Phone (317) 355-5041

7120 Clearvista Dr
Ste 4000
Indianapolis, IN 46256
Phone (317) 621-7444

2420 Lake Ave
Ashtabula, OH 44004
Phone (216) 986-2919

1320 Timken Mercy Dr NW
Canton, OH 44708
Phone (330) 489-1000

3300 Mercy Health Blvd
Cincinnati, OH 45211
Phone (513) 215-1114

4777 E Galbraith Rd
Cincinnati, OH 45236
Phone (513) 686-3000

7500 State Rd
Cincinnati, OH 45255
Phone (513) 624-4034

100 Medical Center Dr
Springfield, OH 45504
Phone (937) 523-1000

Interoperability endpoints

  • Direct secure messaging: jdouglas529510@ecommunitydirect.com

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.

Hospital & facility affiliations 3

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": "1433289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660867200000",
    "number": "1346620564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6626 E 75TH ST STE 500",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462502890",
            "telephone_number": "317-621-7584"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7150 CLEARVISTA DR",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462561695",
            "telephone_number": "317-621-6262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUGLAS",
        "first_name": "JASON",
        "name_prefix": "Dr.",
        "credential": "M.D., M.P.H.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-06-03",
        "last_updated": "2022-08-19",
        "certification_date": "2022-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "57.025883",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IN",
            "license": "01087704A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.