Active NPI
Jacob Boyer, MD
- Student in an Organized Health Care Education/Training Program
- Indianapolis, IN
National Provider Identifier
1447094271
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- License
- 11024374A
- Practice address
- 10122 E 10TH St Ste 100
Indianapolis, IN 46229-2697 - Phone
- (317) 355-5717
- Fax
- (317) 355-3760
- NPI assigned
- Jun 25, 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | 11024374A | IN | Primary |
Addresses
Primary practice location
10122 E 10TH St Ste 100
Indianapolis, IN 46229-2697
Mailing address
10122 E 10TH St Ste 100
Indianapolis, IN 46229-2697
Phone (317) 355-5717
Other practice location 1
5347 N College Ave Apt 316
Indianapolis, IN 46220-3184
Phone (260) 740-4562
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 300114047 | Medicaid | IN |
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: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250606002798 | IN | Order and Referring Only - Family Practice | 7113437328 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Interoperability endpoints
- jboyer649978@ecommunitydirect.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1719273600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1751414400000",
"number": "1447094271",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10122 E 10TH ST STE 100",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462292697",
"telephone_number": "317-355-5717"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10122 E 10TH ST STE 100",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462292697",
"telephone_number": "317-355-5717",
"fax_number": "317-355-3760"
}
],
"practiceLocations": [
{
"address_1": "5347 N College Ave Apt 316",
"address_purpose": "LOCATION",
"city": "Indianapolis",
"state": "IN",
"postal_code": "462203184",
"country_code": "US",
"telephone_number": "260-740-4562",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BOYER",
"first_name": "JACOB",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-06-25",
"last_updated": "2025-07-02",
"certification_date": "2025-07-02",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "IN",
"license": "11024374A",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "300114047",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Indianapolis, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2025; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.