Individual provider Active NPI

Daniel Joseph Jennings, PA-C

  • Physician Assistant
  • Indianapolis, IN
National Provider Identifier
1710596135
Registry record updated Dec 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
10003307A Issued in IN
Practice address
1400 N Ritter Ave Ste 520
Indianapolis, IN 46219-3052
Phone
(317) 355-1234
NPI assigned
Jul 31, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 6, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X
Physician Assistant 363A00000X 10003307A IN Primary

Addresses

Primary practice location

1400 N Ritter Ave Ste 520
Indianapolis, IN 46219-3052

Mailing address

6626 E 75TH St Ste 500
Indianapolis, IN 46250-2890
Phone (317) 621-7547

Other practice location 1

1481 W 10th St
Indianapolis, IN 46202-2803
Phone (317) 910-7314

Other identifiers 1

IdentifierTypeStateIssuer
300067362MedicaidIN

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221129002281 IN Practitioner - Physician Assistant 9234537218 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Physicians of Indiana IncGroup PAC ID 1759416662, 1,569 clinicians
Community Physician Network Specialty Care LLCGroup PAC ID 9931697265, 260 clinicians

Practice addresses (Care Compare)

1400 N Ritter Ave
Indianapolis, IN 46219-3052

1500 N Ritter Ave
Indianapolis, IN 46219-3027

7120 Clearvista Dr
Suite 4000
Indianapolis, IN 46256-1774
Phone (317) 621-7444

8075 N Shadeland Ave
Indianapolis, IN 46250-2693
Phone (317) 621-8000

Hospital & facility affiliations

  • Community Hospital East Hospital, Indianapolis, IN, CCN 150074

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Community Physicians of Indiana Inc CurrentSince Oct 31, 2022 Accepting new patients
Community Physician Network Specialty Care LLC CurrentSince Dec 16, 2025 Accepting new patients
Major Hospital Past Accepting new patients

Locations

5918 Reliable Pkwy
Chicago, IL 60686

5819 Reliable Pkwy
Chicago, IL 60686

1210 Medical Arts Blvd
Ste 104A
Anderson, IN 46011
Phone (317) 355-7220

6626 E 75th St
Ste 500
Indianapolis, IN 46250
Phone (317) 621-7547

1400 N Ritter Ave
Ste 520
Indianapolis, IN 46219
Phone (317) 355-1234

1400 N Ritter Ave
Ste 500
Indianapolis, IN 46219
Phone (317) 355-1234

8075 N Shadeland Ave
Indianapolis, IN 46250
Phone (317) 621-8000

7120 Clearvista Dr
Ste 4000
Indianapolis, IN 46256
Phone (317) 621-7444

Interoperability endpoints

  • Direct secure messaging: djennings537680@ecommunitydirect.com

Organizations & group practices 3

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.

Hospital & facility affiliations 1

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": "1596153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670284800000",
    "number": "1710596135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6626 E 75TH ST STE 500",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462502890",
            "telephone_number": "317-621-7547"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 N RITTER AVE STE 520",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462193052",
            "telephone_number": "317-355-1234"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1481 W 10th St",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462022803",
            "country_code": "US",
            "telephone_number": "317-910-7314",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JENNINGS",
        "first_name": "DANIEL",
        "middle_name": "JOSEPH",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-07-31",
        "last_updated": "2022-12-06",
        "certification_date": "2022-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IN",
            "license": "10003307A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300067362",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.