Individual provider Active NPI

Jennifer Balandran Boyle, M.D.

  • Obstetrics & Gynecology Physician
  • Carmel, IN
National Provider Identifier
1700220720
Registry record updated Apr 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
01080958B Issued in IN
Practice address
11700 N Meridian St
Carmel, IN 46032
Phone
(317) 688-2000
NPI assigned
Apr 21, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X R7958 TX
Student in an Organized Health Care Education/Training Program 390200000X BP10047403 TX
Obstetrics & Gynecology Physician 207V00000X 01080958B IN Primary

Addresses

Primary practice location

11700 N Meridian St
Carmel, IN 46032

Mailing address

3500 Gaston Ave
Dallas, TX 75246-2017
Phone (214) 820-2361

Other identifiers 1

IdentifierTypeStateIssuer
1700220720MedicaidIN

Other names 1

  • Jennifer Balandran Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01080958BINMDObstetrics & Gynecology Physician
BP10047403TXMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Obhg Texas Holdings, P.a. Obstetrics & Gynecology CurrentSince Dec 16, 2019 Accepting new patients

Locations

777 Lowndes Hill Rd
Bldg 1
Greenville, SC 29607
Phone (864) 908-3736

5950 Saratoga Blvd
Corpus Christi, TX 78414
Phone (321) 917-9263

1400 8th Ave
Ft Worth, TX 76104
Phone (817) 922-1559

520 E 6th St
Odessa, TX 79761
Phone (432) 332-0929

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1366502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586822400000",
    "number": "1700220720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3500 GASTON AVE",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752462017",
            "telephone_number": "214-820-2361"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11700 N MERIDIAN ST",
            "city": "CARMEL",
            "state": "IN",
            "postal_code": "46032",
            "telephone_number": "317-688-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOYLE",
        "first_name": "JENNIFER",
        "middle_name": "BALANDRAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-21",
        "last_updated": "2020-04-14",
        "certification_date": "2020-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "TX",
            "license": "R7958",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "TX",
            "license": "BP10047403",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "IN",
            "license": "01080958B",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1700220720",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "BALANDRAN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Carmel, IN

Sources for this page

Verify at the official NPI Registry.