Individual provider Active NPI

Jeffrey C Pauloski, M.D.

  • Obstetrics & Gynecology Physician
  • Fishers, IN
National Provider Identifier
1619967858
Registry record updated May 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
01037714A Issued in IN
Practice address
13914 Southeastern Pkwy
Suite 314
Fishers, IN 46037-7127
Phone
(317) 872-1415
Fax
(317) 773-5945
NPI assigned
Oct 27, 2005
Last updated
May 5, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 5, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 01037714A IN Primary

Addresses

Primary practice location

13914 Southeastern Pkwy
Suite 314
Fishers, IN 46037-7127

Mailing address

13914 Southeastern Parkway
Suite 314
Fishers, IN 46037-7127
Phone (317) 872-1415

Other practice location 1

7150 Clearvista Dr
Indianapolis, IN 46256-1695
Phone (317) 621-6262

Other identifiers 1

IdentifierTypeStateIssuer
100357700MedicaidIN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address Jeffrey.Pauloski@ogi.gwaydirect.com Direct

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
I20070516000281 IN Practitioner - Obstetrics/Gynecology 0244337863 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Indiana University School of Medicine, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2001 W 86TH St
Indianapolis, IN 46260-1902
Phone (317) 338-2345

8240 Naab Rd
Suite 155
Indianapolis, IN 46260-1985
Phone (317) 338-7760

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01037714AINMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Vincent Physician Services Hospital and Health Care Center CurrentSince Mar 1, 2014 Accepting new patients
Community Physicians of Indiana Inc Obstetrics & Gynecology CurrentSince Aug 26, 2021 Accepting new patients
St Vincent Physician Services Hospital and Health Care Center Obstetrics & Gynecology CurrentSince Mar 1, 2014 Accepting new patients
Community Physicians of Indiana Inc CurrentSince Aug 26, 2021 Accepting new patients
Major Hospital Past Accepting new patients

Locations

5819 Reliable Pkwy
Chicago, IL 60686

2015 Jackson St
Anderson, IN 46016
Phone (765) 646-8243

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

7150 Clearvista Dr
Indianapolis, IN 46256
Phone (317) 355-5041

8240 Naab Rd
Ste 155
Indianapolis, IN 46260
Phone (317) 338-7760

Interoperability endpoints

  • Direct secure messaging: jeffrey.pauloski@ogi.gwaydirect.com

Organizations & group practices 5

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.

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": "1130371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651708800000",
    "number": "1619967858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13914 SOUTHEASTERN PARKWAY",
            "address_2": "SUITE 314",
            "city": "FISHERS",
            "state": "IN",
            "postal_code": "460377127",
            "telephone_number": "317-872-1415",
            "fax_number": "317-773-5945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13914 SOUTHEASTERN PKWY",
            "address_2": "SUITE 314",
            "city": "FISHERS",
            "state": "IN",
            "postal_code": "460377127",
            "telephone_number": "317-872-1415",
            "fax_number": "317-773-5945"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7150 Clearvista Dr",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462561695",
            "country_code": "US",
            "telephone_number": "317-621-6262",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PAULOSKI",
        "first_name": "JEFFREY",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-27",
        "last_updated": "2022-05-05",
        "certification_date": "2022-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "IN",
            "license": "01037714A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100357700",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Jeffrey.Pauloski@ogi.gwaydirect.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "13914 Southeastern Pkwy",
            "address_2": "Suite 314",
            "city": "Fishers",
            "state": "IN",
            "country_code": "US",
            "postal_code": "460377127",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fishers, IN

Sources for this page

Verify at the official NPI Registry.