Jana B Chan, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

20043084A Issued in IN

Practice address

355 W 16TH Street Goodman Hall
Indianapolis, IN 46202

Phone

(317) 963-7328

Fax

(317) 963-7313

NPI assigned

Sep 4, 2017

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 2

Other names 1

• Jana B Dykstra Former name

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in IN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Iu Health Medical Group Riley Specialists LLCGroup PAC ID 9638669815, 285 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jdykstra@direct.iuhealth.org

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.

• Iu Health Medical Group Riley Specialists, LLC

  • Pediatrics Physician
  • Indianapolis, IN
  • NPI 1699561480
  Medicare reassignment Care Compare group NPD
• Iu Health Medical Group, LLC

  • General Practice Physician
  • Indianapolis, IN
  • NPI 1326893777
  Medicare reassignment NPD
• Indiana Clinic-Neurology, LLC

  • Neurology Physician
  • Indianapolis, IN
  • NPI 1578792271
  Medicare reassignment

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

{
    "created_epoch": "1504483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741132800000",
    "number": "1497273015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 N SHADELAND AVE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462194959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "355 W 16TH STREET GOODMAN HALL",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "46202",
            "telephone_number": "317-963-7328",
            "fax_number": "317-963-7313"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1701 N Senate Blvd",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462021239",
            "country_code": "US",
            "telephone_number": "888-484-3258",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHAN",
        "first_name": "JANA",
        "middle_name": "B",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-04",
        "last_updated": "2025-03-05",
        "certification_date": "2025-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "IN",
            "license": "20043084A",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IN",
            "license": "20043084A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM PTAN",
            "identifier": "000001115087",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300006445",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "JDYKSTRA@direct.iuhealth.org",
            "affiliation": "N",
            "address_1": "355 W 16th Street Goodman Hall",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "46202",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "JDYKSTRA@direct.iuhealth.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1701 N Senate Blvd",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "462021239",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "JANA",
            "last_name": "DYKSTRA",
            "middle_name": "B",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Nicholas Alan Champlin, PA-C
• Havilah S Champoux, MS, OTR
• Lisa Liman Chan-Owensby, NP
• Consolacion Monica B Chan, FNP-C
• Edward M Chan, M.D.
• Joseph Mun Hoong Chan, MD
• Sophia Chan, RBT
• Christine Chandler
• Courtney Michelle Chandler, LCACA
• Dawn Michelle Chandler, PHARM.D.

• Clinical Psychologist in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Clinical Psychologist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 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.
• 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.