Individual provider Active NPI

Jennifer Kay Magnuson, MD

  • Emergency Medicine Physician
  • Lafayette, IN
National Provider Identifier
1508429648
Registry record updated Dec 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
01089435A Issued in IN
Practice address
5165 McCarty LN
Lafayette, IN 47905-8764
Phone
(765) 448-8000
Fax
(317) 838-4751
NPI assigned
Apr 15, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X R77317 AZ
Emergency Medicine Physician 207P00000X 65773 AZ
Emergency Medicine Physician 207P00000X 01089435A IN Primary

Addresses

Primary practice location

5165 McCarty LN
Lafayette, IN 47905-8764

Mailing address

250 N Shadeland Ave
Indianapolis, IN 46219-4959

Other practice location 1

2800 E Ajo Way
Tucson, AZ 85713-6204
Phone (520) 874-2000

Other identifiers 2

IdentifierTypeStateIssuer
264430H90OtherINMEDICARE PTAN
300080161MedicaidIN

Other names 1

  • Jennifer K Dale Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jmagnuson@direct.iuhealth.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ, IN2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20220613000706 AZ Practitioner - Emergency Medicine 2769717099 Reassigns benefits to 3 organizations
I20230802000124 IN Practitioner - Emergency Medicine 2769717099 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lafayette Emergency Physicians IncGroup PAC ID 9931172863, 22 clinicians

Practice addresses (Care Compare)

1125 W Jefferson St
Franklin, IN 46131-2140
Phone (317) 736-2600

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.78 of 100Reported as apm
Quality
80.38
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
R77317AZMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sound Physicians Emergency Medicine of Arizona, Inc. Emergency Medicine CurrentSince Apr 10, 2024 Accepting new patients
Riverview Hospital CurrentSince Jan 1, 2024 Accepting new patients
Progressive Medical Associates PLLC Emergency Medicine CurrentSince May 17, 2022 Accepting new patients
Indiana University Health Care Associates, Inc CurrentSince Jul 1, 2023 Accepting new patients
Northwest HBP Medical Services LLC Emergency Medicine CurrentSince Jul 19, 2023 Accepting new patients
Riverview Hospital Emergency Medicine CurrentSince Jan 1, 2024 Accepting new patients
Major Hospital Past Accepting new patients

Locations

1400 S Dobson Rd
Mesa, AZ 85202
Phone (480) 412-3000

1171 W Target Range Rd
Nogales, AZ 85621
Phone (520) 285-3000

1551 E Tangerine Rd
Oro Valley, AZ 85755
Phone (520) 901-3500

16260 S Rancho Sahuarita Blvd
Sahuarita, AZ 85629
Phone (520) 416-7100

350 N Wilmot Rd
Tucson, AZ 85711
Phone (520) 873-3000

6200 N La Cholla Blvd
Tucson, AZ 85741
Phone (520) 229-2657

10146 E Old Vail Rd
Tucson, AZ 85747
Phone (520) 229-2657

6350 W Marana Center Blvd
Tucson, AZ 85742
Phone (520) 579-6040

5208 Reliable Pkwy
Chicago, IL 60686

14585 Hazel Dell Pkwy
Rm Urgent
Carmel, IN 46033
Phone (317) 214-5030

9690 E 116th St
Fishers, IN 46037
Phone (317) 214-5750

1125 W Jefferson St
Franklin, IN 46131
Phone (317) 346-3858

250 N Shadeland Ave
Indianapolis, IN 46219
Phone (317) 948-9174

1701 N Senate Blvd
Bldg C6
Indianapolis, IN 46202
Phone (913) 962-2000

5165 McCarty Ln
Lafayette, IN 47905
Phone (800) 899-8448

395 Westfield Rd
Noblesville, IN 46060
Phone (317) 218-3136

5121 Maryland Way
Ste 300
Brentwood, TN 37027
Phone (615) 436-6556

Organizations & group practices 8

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": "1555286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703808000000",
    "number": "1508429648",
    "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": "5165 MCCARTY LN",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479058764",
            "telephone_number": "765-448-8000",
            "fax_number": "317-838-4751"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2800 E Ajo Way",
            "address_purpose": "LOCATION",
            "city": "Tucson",
            "state": "AZ",
            "postal_code": "857136204",
            "country_code": "US",
            "telephone_number": "520-874-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAGNUSON",
        "first_name": "JENNIFER",
        "middle_name": "KAY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-15",
        "last_updated": "2023-12-29",
        "certification_date": "2023-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AZ",
            "license": "R77317",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AZ",
            "license": "65773",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IN",
            "license": "01089435A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "264430H90",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300080161",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jmagnuson@direct.iuhealth.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "5165 McCarty Ln",
            "city": "Lafayette",
            "state": "IN",
            "country_code": "US",
            "postal_code": "479058764",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "DALE",
            "middle_name": "K",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Lafayette, IN

Sources for this page

Verify at the official NPI Registry.