Individual provider Active NPI

Gregory T Jenkins, M.D.

  • Anesthesiology Physician
  • Indianapolis, IN
National Provider Identifier
1639339740
Registry record updated Nov 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
01069231A Issued in IN
Practice address
1120 South Dr
FH 204
Indianapolis, IN 46202-5135
Phone
(317) 274-0274
Fax
(317) 274-0256
NPI assigned
Jun 11, 2008
Last updated
Nov 18, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X IN
Anesthesiology Physician 207L00000X 01069231A IN Primary

Addresses

Primary practice location

1120 South Dr
FH 204
Indianapolis, IN 46202-5135

Mailing address

250 N Shadeland Ave
Indianapolis, IN 46219-4959

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address GJENKINS@direct.iuhealth.org

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
I20120608000351 IN Practitioner - Anesthesiology 1456515154 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Indiana University School of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southeast Anesthesiologists IncGroup PAC ID 6800837980, 91 clinicians

Practice addresses (Care Compare)

8111 S Emerson Ave
Indianapolis, IN 46237-8601
Phone (317) 528-5000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01069231AINMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southeast Anesthesiologists, Inc. Anesthesiology CurrentSince May 1, 2023 Accepting new patients
Iu Anesthesiology Associates, LLC Anesthesiology CurrentSince Jul 1, 2012 Accepting new patients

Locations

1130 W Michigan St
Indianapolis, IN 46202
Phone (317) 274-0076

8111 S Emerson Ave
Indianapolis, IN 46237
Phone (317) 528-5261

250 N Shadeland Ave
Ste 130
Indianapolis, IN 46219
Phone (317) 962-4836

250 N Shadeland Ave
Indianapolis, IN 46219
Phone (317) 948-9174

1130 W Michigan St
#204
Indianapolis, IN 46202
Phone (317) 274-0076

Interoperability endpoints

  • Direct secure messaging: gjenkins@direct.iuhealth.org

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, 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": "1213142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605657600000",
    "number": "1639339740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 N SHADELAND AVE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462194959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 SOUTH DR",
            "address_2": "FH 204",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462025135",
            "telephone_number": "317-274-0274",
            "fax_number": "317-274-0256"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENKINS",
        "first_name": "GREGORY",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-11",
        "last_updated": "2020-11-18",
        "certification_date": "2020-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "IN",
            "license": null,
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IN",
            "license": "01069231A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "GJENKINS@direct.iuhealth.org",
            "affiliation": "N",
            "address_1": "1120 South Dr",
            "address_2": "FH 204",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "462025135",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.