Individual provider Active NPI

Jaclyn James, MD

  • Family Medicine Physician
  • Indianapolis, IN
National Provider Identifier
1619610912
Registry record updated Sep 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
01092108A Issued in IN
Practice address
1112 Southeastern Ave
Indianapolis, IN 46202-3947
Phone
(317) 880-1900
NPI assigned
Apr 15, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 11022168A IN
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X 01092108A IN Primary

Addresses

Primary practice location

1112 Southeastern Ave
Indianapolis, IN 46202-3947

Mailing address

PO Box 637764
Cincinnati, OH 45263-7764
Phone (317) 880-3939

Other practice location 1

10122 E 10th St Ste 100
Indianapolis, IN 46229-2697
Phone (317) 355-5717

Other identifiers 1

IdentifierTypeStateIssuer
300062553MedicaidIN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jjames143404@direct.eskenazihealth.edu

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
I20250717004208 IN Practitioner - Family Practice 2769860832 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1112 Southeastern Ave
Indianapolis, IN 46202-3947
Phone (317) 880-1900

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01092108AINMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Health and Hospital Corporation of Marion County CurrentSince Sep 2, 2025 Accepting new patients
The Health and Hospital Corporation of Marion County Student in an Organized Health Care Education/Training Program CurrentSince Sep 2, 2025 Accepting new patients

Locations

1112 Southeastern Ave
Indianapolis, IN 46202
Phone (317) 423-8909

2732 W Michigan St
Indianapolis, IN 46222
Phone (317) 554-4600

Interoperability endpoints

  • Direct secure messaging: jjames583482@direct.ochin.org
  • Direct secure messaging: jjames527566@ecommunitydirect.com

Organizations & group practices 2

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": "1649980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758499200000",
    "number": "1619610912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 637764",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452637764",
            "telephone_number": "317-880-3939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1112 SOUTHEASTERN AVE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462023947",
            "telephone_number": "317-880-1900"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10122 E 10th St Ste 100",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462292697",
            "country_code": "US",
            "telephone_number": "317-355-5717",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JAMES",
        "first_name": "JACLYN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-15",
        "last_updated": "2025-09-22",
        "certification_date": "2025-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "IN",
            "license": "11022168A",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01092108A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300062553",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jjames143404@direct.eskenazihealth.edu",
            "affiliation": "N",
            "address_1": "1112 Southeastern Ave",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "462023947",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.