Individual provider Active NPI

Jennifer R Corsbie, PA-C

  • Physician Assistant
  • Hobart, IN
National Provider Identifier
1497103352
Registry record updated Oct 11, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
1400 S Lake Park Ave
Suite 200
Hobart, IN 46342-6790
Phone
(219) 947-6122
NPI assigned
Jun 1, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

1400 S Lake Park Ave
Suite 200
Hobart, IN 46342-6790

Mailing address

1400 S Lake Park Ave
Suite 200
Hobart, IN 46342-6790

Other names 1

  • Jennifer R Simatovich Former name

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
I20161123001467 IN Practitioner - Physician Assistant 4880973387 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Indiana University School of Medicine, 2016
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)

1400 S Lake Park Ave
Hobart, IN 46342-6791

1500 S Lake Park Ave
Hobart, IN 46342-6638

801 Macarthur Blvd
Munster, IN 46321-2919

901 Macarthur Blvd
Munster, IN 46321-2901
Phone (219) 836-4563

9130 Columbia Ave
Munster, IN 46321-2932

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Community Care Network Inc Physician Assistant CurrentSince Sep 24, 2016 Accepting new patients
St Mary Medical Center Inc Past Accepting new patients

Locations

1400 S Lake Park Ave
Ste 200
Hobart, IN 46342
Phone (219) 947-5606

1400 S Lake Park Ave
Ste 200202
Hobart, IN 46342
Phone (219) 947-6122

1500 S Lake Park Ave
Hobart, IN 46342
Phone (219) 942-0551

9130 Columbia Ave
Ste A
Munster, IN 46321
Phone (219) 365-1166

801 MacArthur Blvd
Ste 402
Munster, IN 46321
Phone (219) 513-0233

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 3

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": "1464739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476144000000",
    "number": "1497103352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 S LAKE PARK AVE",
            "address_2": "SUITE 200",
            "city": "HOBART",
            "state": "IN",
            "postal_code": "463426790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 S LAKE PARK AVE",
            "address_2": "SUITE 200",
            "city": "HOBART",
            "state": "IN",
            "postal_code": "463426790",
            "telephone_number": "219-947-6122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORSBIE",
        "first_name": "JENNIFER",
        "middle_name": "R",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-01",
        "last_updated": "2016-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "SIMATOVICH",
            "middle_name": "R",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Hobart, IN

Sources for this page

Verify at the official NPI Registry.