Individual provider Active NPI

Jennifer L Dorantes, MD

  • Internal Medicine Physician
  • Carmel, IN
National Provider Identifier
1508870221
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
223928 Issued in MA
Practice address
11911 N Meridian St Ste 110
Carmel, IN 46032-6919
Phone
(317) 621-6800
Fax
(317) 621-6808
NPI assigned
Jul 28, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 223928 MA Primary

Addresses

Primary practice location

11911 N Meridian St Ste 110
Carmel, IN 46032-6919

Mailing address

280 Chestnut St
2ND Floor
Springfield, MA 01199-1001
Phone (413) 794-5700

Other practice location 1

2344 Boston Rd
Wilbraham, MA 01095-1104
Phone (413) 596-5550

Other identifiers 1

IdentifierTypeStateIssuer
300004779MedicaidIN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jdorantes290398@eCommunityDirect.com Community Physicians of Indiana Inc

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171107003504 IN Practitioner - Internal Medicine 1355387796 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Rochester School of Medicine and Dentistry, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Community Physicians of Indiana IncGroup PAC ID 1759416662, 1,569 clinicians
Select Rehabilitation, LLCGroup PAC ID 9032020490, 1,935 clinicians

Practice addresses (Care Compare)

11911 N Meridian St
Suite 110
Carmel, IN 46032-6919
Phone (317) 621-1151

2600 Compass Rd
Glenview, IL 60026-8001

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
223928MAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Community Physicians of Indiana Inc CurrentSince Nov 6, 2017 Accepting new patients
Community Physicians of Indiana Inc Internal Medicine CurrentSince Nov 6, 2017 Accepting new patients
Baystate Affiliated Practice Organization Internal Medicine Past Accepting new patients

Locations

5819 Reliable Pkwy
Chicago, IL 60686

11911 N Meridian St
Ste 110
Carmel, IN 46032
Phone (317) 571-1151

7120 Clearvista Dr
Ste 4000
Indianapolis, IN 46256
Phone (317) 621-7444

6626 E 75th St
Ste 500
Indianapolis, IN 46250
Phone (317) 621-7547

Interoperability endpoints

  • Direct secure messaging: jdorantes290398@ecommunitydirect.com

Organizations & group practices 4

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 7

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": "1154044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1508870221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "280 CHESTNUT ST",
            "address_2": "2ND FLOOR",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011991001",
            "telephone_number": "413-794-5700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11911 N MERIDIAN ST STE 110",
            "city": "CARMEL",
            "state": "IN",
            "postal_code": "460326919",
            "telephone_number": "317-621-6800",
            "fax_number": "317-621-6808"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2344 Boston Rd",
            "address_purpose": "LOCATION",
            "city": "Wilbraham",
            "state": "MA",
            "postal_code": "010951104",
            "country_code": "US",
            "telephone_number": "413-596-5550",
            "fax_number": "413-794-2551",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DORANTES",
        "first_name": "JENNIFER",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-28",
        "last_updated": "2023-11-27",
        "certification_date": "2020-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "223928",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300004779",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jdorantes290398@eCommunityDirect.com",
            "affiliation": "Y",
            "affiliationName": "Community Physicians of Indiana Inc",
            "address_1": "11911 N Meridian St Ste 110",
            "city": "Carmel",
            "state": "IN",
            "country_code": "US",
            "postal_code": "460326919",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Carmel, IN

Sources for this page

Verify at the official NPI Registry.