Jamie Peters, PA
Individual provider Active NPI Physician Assistant · Indianapolis, IN
NPI 1659570554 · NPPES record last updated Jun 25, 2024
Key facts
- NPI
- 1659570554
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- 10000946A (IN)
- Practice address
- 8333 Naab Rd Ste 200
Indianapolis, IN 46260-1973 - Phone
- (317) 338-4400
- NPI assigned
- Jul 12, 2007
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 11
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2007
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- St Vincent Medical Group Inc
Practice addresses (Care Compare)
2001 W 86TH St
Indianapolis, IN 46260-1902
Phone (317) 338-2345
8433 Harcourt Rd
Suite 100
Indianapolis, IN 46260-2193
Phone (317) 583-7600
Hospital & facility affiliations
- Ascension St Vincent Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20070728000209 | IN | Practitioner - Physician Assistant | 3173624509 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10000946A | IN | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St. Vincent Medical Group, Inc. | Physician Assistant | Current |
Accepting new patients |
| St. Vincent Medical Group, Inc. | Current |
Accepting new patients | |
| Cep America LLC | Current |
Accepting new patients | |
| Cep America LLC | Current |
Accepting new patients | |
| St Vincent Medical Group Inc | Past | Accepting new patients | |
| Icem, LLC | Past | Accepting new patients |
Locations
2100 Powell St
Ste 400
Emeryville, CA 94608
Phone (510) 350-2638
1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423
1111 Ronald Reagan Pkwy
Avon, IN 46123
Phone (317) 217-3000
1600 Albany St
Beech Grove, IN 46107
Phone (317) 783-8148
13450 N Meridian St
Ste 145
Carmel, IN 46032
Phone (317) 338-4303
13861 Olio Rd
Fishers, IN 46037
Phone (317) 338-7136
8333 Naab Rd
Ste 200
Indianapolis, IN 46260
Phone (317) 338-4400
8433 Harcourt Rd
Ste 100
Indianapolis, IN 46260
Phone (317) 583-7702
2001 W 86th St
Indianapolis, IN 46260
Phone (317) 338-3617
1201 Hadley Rd
Mooresville, IN 46158
Phone (317) 783-8148
395 Westfield Rd
Noblesville, IN 46060
Phone (317) 218-3136
1606 N 7th St
Terre Haute, IN 47804
Phone (812) 238-7523
Interoperability endpoints
- jamie.vanderwielen.1@7598.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 10000946A | IN | Yes |
Addresses
Primary practice location
8333 Naab Rd Ste 200
Indianapolis, IN 46260-1973
Mailing address
8333 Naab Rd Ste 200
Indianapolis, IN 46260-1973
Other practice location 1
1600 Albany St
Beech Grove, IN 46107-1541
Phone (317) 783-8148
Other names
- Jamie Vanderwielen
Other providers in Indianapolis, IN
- Annah Peters
- Audrey Lynn Peters
- Elizabeth Peters
- Emily Marie Peters
- Faye Louise Peters
- John Gerard Peters
- Kasey Peters
- Kelly Peters
- Machaela Marie Peters
- Melissa Peters
All providers in Indianapolis, IN · Physician Assistant in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 25, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.