Active NPI
Jesse R Amezaga, MD
- Diagnostic Radiology Physician
- Grand Rapids, MI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- 4301078261
- Practice address
- 3264 N Evergreen Dr NE
Grand Rapids, MI 49525-9746 - Phone
- (616) 363-7272
- Fax
- (616) 361-5828
- NPI assigned
- Jun 6, 2006
- Last updated
- Jul 18, 2024
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | 0101278889 | VA | |
| Diagnostic Radiology Physician | 2085R0202X | 01093995A | IN | |
| Diagnostic Radiology Physician | 2085R0202X | 4301078261 | MI | Primary |
Addresses
Primary practice location
3264 N Evergreen Dr NE
Grand Rapids, MI 49525-9746
Mailing address
3264 N Evergreen Dr NE
Grand Rapids, MI 49525-9746
Phone (616) 363-7272
Other practice location 1
5165 McCarty Ln
Lafayette, IN 47905-8764
Phone (765) 448-8000
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | jamezaga@direct.iuhealth.org | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI, NC, VA, IN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 4
Care Compare profile
Medicare Care Compare- Specialty
- Diagnostic Radiology
- Education
- Other, 2001
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1701 N Senate Blvd
Indianapolis, IN 46202-1239
Phone (888) 484-3258
5165 McCarty LN
Lafayette, IN 47905-8764
Phone (765) 448-8000
Hospital & facility affiliations
- Indiana University Health Arnett Hospital
- Indiana University Health White Memorial Hospital
- Indiana University Health Frankfort Inc
- Franciscan Health Lafayette
- Franciscan Health Rensselaer, Inc
Merit-based Incentive Payment System (MIPS)
- Final score
- 93.16 of 100
- Quality
- 83.58
- Promoting interoperability
- 94
- Improvement activities
- 40
Merit-based Incentive Payment System (MIPS)
- Final score
- 93.55 of 100
- Quality
- 100
- Improvement activities
- 40
- Cost
- 78.49
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0101278889 | VA | MD | Diagnostic Radiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Arnett Clinic, LLC | Diagnostic Radiology | Current | Accepting new patients |
| Iu Health Medical Group, LLC | Current | Accepting new patients | |
| Arnett Clinic, LLC | Current | Accepting new patients | |
| Arnett Clinic, LLC | Current | Accepting new patients | |
| Raleigh Radiology, LLC | Diagnostic Radiology | Current | Accepting new patients |
| Oakwood Healthcare Inc | Past | Accepting new patients | |
| Insight Radiology, P.C. | Diagnostic Radiology | Past | Accepting new patients |
Locations
8016 Reliable Pkwy
Chicago, IL 60686
1701 Senate Blvd
Indianapolis, IN 46202
Phone (317) 612-2754
250 N Shadeland Ave
Indianapolis, IN 46219
Phone (317) 948-9174
2600 Greenbush St
Lafayette, IN 47904
5165 McCarty Ln
Lafayette, IN 47905
Phone (800) 899-8448
5165 McCarty Ln
Rm 28A
Lafayette, IN 47905
150 Parkway Office Ct
Ste 100
Cary, NC 27518
3200 Blue Ridge Rd
Ste 100
Raleigh, NC 27612
Phone (919) 256-3576
5220 Greens Dairy Rd
Raleigh, NC 27616
Phone (540) 493-4581
1901 Tate Springs Rd
Lynchburg, VA 24501
Phone (434) 200-3101
320 Hospital Dr
Martinsville, VA 24112
Phone (276) 666-7200
Interoperability endpoints
- jamezaga@direct.iuhealth.org
- jamezaga58546@direct.hfhs.org
Organizations & group practices 8
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.
-
- General Practice Physician
- Indianapolis, IN
- NPI 1326893777
-
- Durable Medical Equipment & Medical Supplies
- Lafayette, IN
- NPI 1699839563
-
- Clinical Medical Laboratory
- Lafayette, IN
- NPI 1881655090
-
- Diagnostic Radiology Physician
- Kalamazoo, MI
- NPI 1306892740
-
dba Corewell Health Retail Pharmacy Westland
- Community/Retail Pharmacy
- Westland, MI
- NPI 1033128178
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Franciscan St. Elizabeth Health
- General Acute Care Hospital
- Lafayette, IN
- NPI 1356435341
-
dba Franciscan Healthcare Rensselaer
- Critical Access Hospital
- Rensselaer, IN
- NPI 1932589173
-
dba IU Health Arnett Hospital
- General Acute Care Hospital
- Lafayette, IN
- NPI 1326296211
-
- Critical Access Hospital
- Frankfort, IN
- NPI 1346774270
-
- Critical Access Hospital
- Monticello, IN
- NPI 1710983945
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149552000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1721260800000",
"number": "1386683209",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3264 N EVERGREEN DR NE",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495259746",
"telephone_number": "616-363-7272",
"fax_number": "616-361-5828"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3264 N EVERGREEN DR NE",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495259746",
"telephone_number": "616-363-7272",
"fax_number": "616-361-5828"
}
],
"practiceLocations": [
{
"address_1": "5165 McCarty Ln",
"address_purpose": "LOCATION",
"city": "Lafayette",
"state": "IN",
"postal_code": "479058764",
"country_code": "US",
"telephone_number": "765-448-8000",
"fax_number": "765-448-8621",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "AMEZAGA",
"first_name": "JESSE",
"middle_name": "R",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-06",
"last_updated": "2024-07-18",
"certification_date": "2024-07-18",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "VA",
"license": "0101278889",
"primary": false
},
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "IN",
"license": "01093995A",
"primary": false
},
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "MI",
"license": "4301078261",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "jamezaga@direct.iuhealth.org",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "5165 McCarty Ln",
"city": "Lafayette",
"state": "IN",
"country_code": "US",
"postal_code": "479058764",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Grand Rapids, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2024; 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.