Individual provider Active NPI

Jessica Danielle Wilkins

  • Anesthesiologist Assistant
  • Indianapolis, IN
National Provider Identifier
1447902093
Registry record updated Jan 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiologist AssistantTaxonomy code 367H00000X
License
75000102A Issued in IN
Practice address
1701 N Senate Ave
Indianapolis, IN 46202-5306
Phone
(317) 962-2000
NPI assigned
Jan 25, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 25, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiologist Assistant 367H00000X 75000102A IN Primary

Addresses

Primary practice location

1701 N Senate Ave
Indianapolis, IN 46202-5306

Mailing address

5533 Brentwick PL
Indianapolis, IN 46237-6394
Phone (812) 549-8665

Other practice location 1

550 University Blvd
Indianapolis, IN 46202-5149
Phone (317) 944-5000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220808001128 IN Practitioner - Anesthesiology Assistant 0446632491 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

520 S 7TH St
Vincennes, IN 47591-1038
Phone (812) 885-3280

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Iu Anesthesiology Associates, LLC CurrentSince Apr 6, 2022 Accepting new patients
Good Samaritan Hospital Physician Services, Inc CurrentSince Oct 1, 2023 Accepting new patients
Good Samaritan Hospital CurrentSince Oct 1, 2023 Accepting new patients

Locations

1130 W Michigan St
Indianapolis, IN 46202
Phone (317) 274-0076

550 University Blvd
Indianapolis, IN 46202
Phone (217) 274-5000

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

520 S 7th St
Vincennes, IN 47591
Phone (812) 885-3280

1160 E Saint Clair St
Vincennes, IN 47591
Phone (812) 882-1064

Organizations & group practices 3

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": "1643068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643068800000",
    "number": "1447902093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5533 BRENTWICK PL",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462376394",
            "telephone_number": "812-549-8665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 N SENATE AVE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462025306",
            "telephone_number": "317-962-2000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "550 University Blvd",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462025149",
            "country_code": "US",
            "telephone_number": "317-944-5000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILKINS",
        "first_name": "JESSICA",
        "middle_name": "DANIELLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-01-25",
        "last_updated": "2022-01-25",
        "certification_date": "2022-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367H00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiologist Assistant",
            "state": "IN",
            "license": "75000102A",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Jan 25, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.