Carly Jane Jensen, NP

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

71015489A Issued in IN

Practice address

550 University Blvd Ste 4601
Indianapolis, IN 46202-5149

Phone

(317) 944-4370

Fax

(317) 968-1254

NPI assigned

Apr 11, 2024

Last updated

Oct 3, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 3

Other names 1

• Carly Jane Burger Former name

Electronic endpoints 1

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

Specialty

Nurse Practitioner

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Iu Health Medical Group LLCGroup PAC ID 9638617913, 4,382 clinicians

Clarian Transplant Institute, Inc.Group PAC ID 4284724949, 14 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Indiana University Health Hospital, Indianapolis, IN, CCN 150056

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Clarian Transplant Institute, Inc.

  • Transplant Surgery Physician
  • Indianapolis, IN
  • NPI 1023204146
  Medicare reassignment Care Compare group NPD
• Iu Health Medical Group, LLC

  • General Practice Physician
  • Indianapolis, IN
  • NPI 1326893777
  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Indiana University Health Inc

  dba Indiana University Health

  • General Acute Care Hospital
  • Indianapolis, IN
  • NPI 1144266024
  Care Compare affiliation

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

{
    "created_epoch": "1712793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727913600000",
    "number": "1396599932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "147 EASTERN AVE",
            "city": "PLAINFIELD",
            "state": "IN",
            "postal_code": "461681301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 UNIVERSITY BLVD STE 4601",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462025149",
            "telephone_number": "317-944-4370",
            "fax_number": "317-968-1254"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "147 Eastern Ave",
            "address_purpose": "LOCATION",
            "city": "Plainfield",
            "state": "IN",
            "postal_code": "461681301",
            "country_code": "US",
            "telephone_number": "317-697-5015",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JENSEN",
        "first_name": "CARLY",
        "middle_name": "JANE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-04-11",
        "last_updated": "2024-10-03",
        "certification_date": "2024-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "IN",
            "license": "71015489A",
            "primary": true
        },
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "IN",
            "license": "28210211A",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM PTAN",
            "identifier": "1104324845",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "254330016",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300095114",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cjensen@direct.iuhealth.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "550 University Blvd Ste 4601",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "462025149",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "CARLY",
            "last_name": "BURGER",
            "middle_name": "JANE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Gloria C Jennings, O.D.
• Jamie Jennings
• Joyce M Jennings, LCSW
• Marisa Pyatt Jennings, MSSW
• Shelby Rae Jennings
• Chico Jensen
• Garrett L Jensen, MD
• Katelyn Jensen, MS, RD, LD
• Katherine Anne Jensen, ATC
• Valeska Jensen

• Gerontology Nurse Practitioner in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Gerontology Nurse Practitioner in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 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.

Verify at the official NPI Registry.