Individual provider Active NPI

Jeremy W Algate

  • Clinical Social Worker
  • Indianapolis, IN
National Provider Identifier
1558069203
Registry record updated Nov 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
34009719A Issued in IN
Practice address
8401 Harcourt Rd
Indianapolis, IN 46260-2036
Phone
(317) 338-4600
NPI assigned
Feb 22, 2023
Last updated
Nov 11, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 34009719A IN Primary

Addresses

Primary practice location

8401 Harcourt Rd
Indianapolis, IN 46260-2036

Mailing address

8401 Harcourt Rd
Indianapolis, IN 46260-2036

Other practice location 1

2680 E Main St Ste 227
Plainfield, IN 46168-2830
Phone (765) 787-1195

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231127001250 IN Practitioner - Clinical Social Worker 8820459134 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

8401 Harcourt Rd
Suite 302
Indianapolis, IN 46260-2036
Phone (317) 338-4600

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
34009719AINMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
St. Vincent Hospital & Health Care Center, Inc. CurrentSince Jan 1, 2024 Accepting new patients
St. Vincent Hospital & Health Care Center, Inc. CurrentSince Jan 1, 2024 Accepting new patients
Mulberry Therapeutics Services, LLC Clinical CurrentSince Aug 18, 2024 Accepting new patients

Locations

250 W 96th St
Ste 520
Indianapolis, IN 46260
Phone (317) 583-3211

8401 Harcourt Rd
Indianapolis, IN 46260
Phone (317) 338-4600

8401 Harcourt Rd
Ste 302
Indianapolis, IN 46260
Phone (317) 338-4600

2680 E Main St
Ste 227
Plainfield, IN 46168
Phone (765) 787-1195

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1677024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731283200000",
    "number": "1558069203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8401 HARCOURT RD",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462602036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8401 HARCOURT RD",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462602036",
            "telephone_number": "317-338-4600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2680 E Main St Ste 227",
            "address_purpose": "LOCATION",
            "city": "Plainfield",
            "state": "IN",
            "postal_code": "461682830",
            "country_code": "US",
            "telephone_number": "765-787-1195",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ALGATE",
        "first_name": "JEREMY",
        "middle_name": "W",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-02-22",
        "last_updated": "2024-11-11",
        "certification_date": "2024-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34009719A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.