Jacob Johnston Nolan, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

10002996A Issued in IN

Practice address

2824 Elkhart Rd
Goshen, IN 46526-1014

Phone

(574) 535-1700

Fax

(574) 535-1799

NPI assigned

Nov 3, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 2

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Maple City Health Care Center IncGroup PAC ID 2163569401, 29 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Goshen Hospital Hospital, Goshen, IN, CCN 150026

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jacob.nolan@goshenhealthdirect.com

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.

• Maple City Health Care Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Goshen, IN
  • NPI 1033166095
  Medicare reassignment Care Compare group
• Goshen Health System Inc

  • Family Medicine Physician
  • Goshen, IN
  • NPI 1194772293
  NPD
• Maple City Health Care Center, Inc

  • Federally Qualified Health Center (FQHC)
  • Goshen, IN
  • NPI 1275220303
  NPD
• Northeast Internal Medicine Associates, PC

  • Internal Medicine Physician
  • Lagrange, IN
  • NPI 1174518500
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Goshen Hospital Association Inc

  • General Acute Care Hospital
  • Goshen, IN
  • NPI 1740268846
  Care Compare affiliation

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

{
    "created_epoch": "1604361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682035200000",
    "number": "1689275000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2824 ELKHART RD",
            "city": "GOSHEN",
            "state": "IN",
            "postal_code": "465261014",
            "telephone_number": "574-825-3888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2824 ELKHART RD",
            "city": "GOSHEN",
            "state": "IN",
            "postal_code": "465261014",
            "telephone_number": "574-535-1700",
            "fax_number": "574-535-1799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOLAN",
        "first_name": "JACOB",
        "middle_name": "JOHNSTON",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-11-03",
        "last_updated": "2023-04-21",
        "certification_date": "2023-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IN",
            "license": "10002996A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jacob.nolanpa.p1@direct.goshenphysicians.nextgeshare.com",
            "affiliation": "N",
            "address_1": "2824 Elkhart Rd",
            "city": "Goshen",
            "state": "IN",
            "country_code": "US",
            "postal_code": "465261014",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jacob.nolan@goshenhealthdirect.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "2824 Elkhart Rd",
            "city": "Goshen",
            "state": "IN",
            "country_code": "US",
            "postal_code": "465261014",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Marion Nyaguthii Nganga
• Sultan O. Niazi, M.D.
• Alyssa Nichols, EDS
• Zoey Nickell
• Kryston Jean Noble-Hartzler, LCSW, LCAC
• Alyssa Norris
• Nurses at Heart Home Care LLC
• Timothy W Nush, MD
• Elizabeth Nussbaum-Gonzalez, LSW
• Lindsey Leigh O'Dell, OTR

• Physician Assistant in Goshen, IN
• Providers in Goshen, IN by specialty
• Physician Assistant in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.