Jamie M Markulin, AGCNS-BC

Primary specialty

Gerontology Clinical Nurse SpecialistTaxonomy code 364SG0600X

License

71012539A Issued in IN

Practice address

9120 Columbia Ave
Munster, IN 46321-2907

Phone

(219) 703-5301

Fax

(219) 703-6718

NPI assigned

Apr 29, 2022

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 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, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Community Care Network IncGroup PAC ID 3678737012, 378 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Community Hospital Hospital, Munster, IN, CCN 150125

Medicare enrollment (NPD)

Enrolled

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 and National Provider Directory roles.

• Community Care Network Inc

  • Family Medicine Physician
  • St John, IN
  • NPI 1457610487
  Medicare reassignment Care Compare group NPD

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

• Munster Medical Research Foundation Inc

  • General Acute Care Hospital
  • Munster, IN
  • NPI 1003918210
  Care Compare affiliation

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

{
    "created_epoch": "1651190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653609600000",
    "number": "1457096935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8558 BROADWAY",
            "city": "MERRILLVILLE",
            "state": "IN",
            "postal_code": "464107032",
            "telephone_number": "219-392-7084",
            "fax_number": "219-703-6854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9120 COLUMBIA AVE",
            "city": "MUNSTER",
            "state": "IN",
            "postal_code": "463212907",
            "telephone_number": "219-703-5301",
            "fax_number": "219-703-6718"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARKULIN",
        "first_name": "JAMIE",
        "middle_name": "M",
        "credential": "AGCNS-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-29",
        "last_updated": "2022-05-27",
        "certification_date": "2022-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SG0600X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Gerontology",
            "state": "IN",
            "license": "71012539A",
            "primary": true
        },
        {
            "code": "364SG0600X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Gerontology",
            "state": "IN",
            "license": "28204648A",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300061751",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Avalon Marciniak
• Mariah Marine
• Mark Nootens, MD, PC
• Amber Markasovic, MS CCC-SLP
• Alyssa Markle, FNP-C
• John Michael Marogol, PA
• Rose Mary Marsee, CRNA
• Martell Polite Dental PC
• Denise M Marthakis, RPH
• Alyssa Michelle Martin

• Gerontology Clinical Nurse Specialist in Munster, IN
• Providers in Munster, IN by specialty
• Gerontology Clinical Nurse Specialist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2022; 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.