Individual provider Active NPI

Jacob P Erdely, NP

  • Family Nurse Practitioner
  • Carmel, IN
National Provider Identifier
1417614678
Registry record updated Aug 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
71012274A Issued in IN
Practice address
13430 N Meridian St Ste 367
Carmel, IN 46032-1484
Phone
(317) 802-2000
Fax
(317) 569-0573
NPI assigned
Nov 23, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 28205845A IN
Nurse Practitioner 363L00000X 71012274A IN
Family Nurse Practitioner 363LF0000X 71012274A IN Primary

Addresses

Primary practice location

13430 N Meridian St Ste 367
Carmel, IN 46032-1484

Mailing address

13430 N Meridian St Ste 367
Carmel, IN 46032-1484
Phone (317) 802-2000

Other practice location 1

8450 Northwest Blvd
Indianapolis, IN 46278-1381
Phone (317) 802-2000

Other practice location 2

5501 W Bethel Ave
Muncie, IN 47304-8513
Phone (765) 741-2957

Other identifiers 1

IdentifierTypeStateIssuer
9590909203OtherINMEDICARE PTAN

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address jacoberdely@oi.allscriptsdirect.net Orthopaedics-Indianapolis, Inc.
Direct Messaging Address jerdely@direct.iuhealth.org 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
I20220301001683 IN Practitioner - Nurse Practitioner 8426442823 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Indiana University Radiology Associates IncGroup PAC ID 7315922267, 213 clinicians
Iu Health Medical Group LLCGroup PAC ID 9638617913, 4,382 clinicians

Practice addresses (Care Compare)

1111 Ronald Reagan Pkwy
Avon, IN 46123-7085
Phone (317) 963-0166

1701 N Senate Blvd
Indianapolis, IN 46202-1239
Phone (888) 484-3258

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
28205845AINMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Iu Health Medical Group, LLC Nurse Practitioner CurrentSince Oct 1, 2025 Accepting new patients
Indiana University Radiology Associates, Inc. CurrentSince Sep 1, 2023 Accepting new patients

Locations

5924 Reliable Pkwy
Chicago, IL 60686

1111 Ronald Reagan Pkwy
Avon, IN 46123
Phone (317) 217-3000

250 N Shadeland Ave
Indianapolis, IN 46219
Phone (317) 948-9174

1701 Senate Blvd
Indianapolis, IN 46202
Phone (317) 612-2754

6850 Parkdale Pl
Indianapolis, IN 46254
Phone (317) 329-7209

1701 Senate Blvd
#C6
Indianapolis, IN 46202
Phone (317) 962-9000

5501 W Bethel Ave
Muncie, IN 47304
Phone (765) 741-2957

Interoperability endpoints

  • Direct secure messaging: jerdely110895@direct.eskenazihealth.edu
  • Direct secure messaging: jerdely@direct.iuhealth.org

Organizations & group practices 2

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.

Hospital & facility affiliations 2

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": "1637625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693440000000",
    "number": "1417614678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13430 N MERIDIAN ST STE 367",
            "city": "CARMEL",
            "state": "IN",
            "postal_code": "460321484",
            "telephone_number": "317-802-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13430 N MERIDIAN ST STE 367",
            "city": "CARMEL",
            "state": "IN",
            "postal_code": "460321484",
            "telephone_number": "317-802-2000",
            "fax_number": "317-569-0573"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8450 Northwest Blvd",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462781381",
            "country_code": "US",
            "telephone_number": "317-802-2000",
            "fax_number": "317-802-2401",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5501 W Bethel Ave",
            "address_purpose": "LOCATION",
            "city": "Muncie",
            "state": "IN",
            "postal_code": "473048513",
            "country_code": "US",
            "telephone_number": "765-741-2957",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ERDELY",
        "first_name": "JACOB",
        "middle_name": "P",
        "name_prefix": "Mr.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-11-23",
        "last_updated": "2023-08-31",
        "certification_date": "2023-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IN",
            "license": "28205845A",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IN",
            "license": "71012274A",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71012274A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "9590909203",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jacoberdely@oi.allscriptsdirect.net",
            "affiliation": "Y",
            "endpointDescription": "Allscripts e-mail",
            "affiliationName": "Orthopaedics-Indianapolis, Inc.",
            "address_1": "13430 N Meridian St Ste 367",
            "city": "Carmel",
            "state": "IN",
            "country_code": "US",
            "postal_code": "460321484",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jerdely@direct.iuhealth.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "5501 W Bethel Ave",
            "city": "Muncie",
            "state": "IN",
            "country_code": "US",
            "postal_code": "473048513",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Carmel, IN

Sources for this page

Verify at the official NPI Registry.