Individual provider Active NPI

John Peter Kern III, PA-C

  • Physician Assistant
  • Crown Point, IN
National Provider Identifier
1598366155
Registry record updated Nov 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
11275 Delaware Pkwy
Crown Point, IN 46307-7812
Phone
(219) 779-8735
NPI assigned
Nov 2, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2020

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

11275 Delaware Pkwy
Crown Point, IN 46307-7812

Mailing address

9063 Cleveland CT Apt 102
Merrillville, IN 46410-0023
Phone (847) 609-7829

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
I20210218001348 IN Practitioner - Physician Assistant 8820403199 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Indiana Sports and Medical Science Institute, PCGroup PAC ID 2860662517, 7 clinicians

Practice addresses (Care Compare)

11275 Delaware Pkwy
Suite a
Crown Point, IN 46307-7812
Phone (219) 779-8735

Hospital & facility affiliations

  • Elara Caring Home health agency, Valparaiso, IN, CCN 157095
  • Franciscan Health Crown Point Hospital, Crown Point, IN, CCN 150126
  • Community Hospital Hospital, Munster, IN, CCN 150125

National Provider Directory

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

Interoperability endpoints

  • Direct secure messaging: jkern@isamsip-in.direct.office.nextgen.com

Organizations & group practices 1

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": "1604275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604275200000",
    "number": "1598366155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9063 CLEVELAND CT APT 102",
            "city": "MERRILLVILLE",
            "state": "IN",
            "postal_code": "464100023",
            "telephone_number": "847-609-7829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11275 DELAWARE PKWY",
            "city": "CROWN POINT",
            "state": "IN",
            "postal_code": "463077812",
            "telephone_number": "219-779-8735"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KERN",
        "first_name": "JOHN",
        "middle_name": "PETER",
        "name_suffix": "III",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-11-02",
        "last_updated": "2020-11-02",
        "certification_date": "2020-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crown Point, IN

Sources for this page

Verify at the official NPI Registry.