Active NPI
Daniel Joseph Jennings, PA-C
- Physician Assistant
- Indianapolis, IN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 10003307A
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 300067362 | Medicaid | IN |
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
Enrollment records 1
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
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
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Community Physicians of Indiana Inc | Current | Accepting new patients | |
| Community Physician Network Specialty Care LLC | Current | 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
- 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.
-
- Cardiovascular Disease Physician
- Indianapolis, IN
- NPI 1588535496
-
- Family Medicine Physician
- Indianapolis, IN
- NPI 1619105244
-
- General Acute Care Hospital
- Shelbyville, IN
- NPI 1174555692
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Indianapolis, IN
- NPI 1336119478
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2022; 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.