Jillian Hubertz, AUD

Primary specialty

AudiologistTaxonomy code 231H00000X

License

23002574A Issued in IN

Practice address

10021 Dupont Circle CT
Fort Wayne, IN 46825-1604

Phone

(260) 426-8117

Fax

(260) 420-0817

NPI assigned

Jun 24, 2015

Last updated

Oct 28, 2015By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Jillian Wendel Former name

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

Specialty

Qualified Audiologist

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Trustees of Purdue UniversityGroup PAC ID 2567373012, 28 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Trustees of Purdue University

  dba M D Steer Audiology & Speech-Language Clinics

  • Hearing and Speech Clinic/Center
  • West Lafayette, IN
  • NPI 1619055712
  Medicare reassignment Care Compare group NPD
• Trustees of Purdue University

  dba Family Health Clinic of Wolcott

  • Federally Qualified Health Center (FQHC)
  • Wolcott, IN
  • NPI 1598111791
  NPD
• Purdue University

  dba Purdue University Student Health Center

  • Student Health Clinic/Center
  • West Lafayette, IN
  • NPI 1346239696
  NPD (past)

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

{
    "created_epoch": "1435104000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1445990400000",
    "number": "1649652835",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10021 DUPONT CIRCLE CT",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468251604",
            "telephone_number": "260-426-8117",
            "fax_number": "260-420-0817"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10021 DUPONT CIRCLE CT",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468251604",
            "telephone_number": "260-426-8117",
            "fax_number": "260-420-0817"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUBERTZ",
        "first_name": "JILLIAN",
        "credential": "AUD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-24",
        "last_updated": "2015-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "IN",
            "license": "23002574A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201305500",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JILLIAN",
            "last_name": "WENDEL",
            "credential": "AUD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Brendan Hubbard
• Michelle Hubble, MA
• Jennifer L. Huber, DO
• Kimberly J Huber, M.S.E.D., LMFTA
• Timothy Huber, P.T.
• Brenda Carol Hubler
• Dominic John-Paul Hubley, NP-C
• Kronda Nicole Huddleston
• John C. Huddlestone, M.S., LCSW, LMFT
• Ashley Margaret Hudson, BCBA

• Audiologist in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Audiologist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.