Individual provider Active NPI

James Worman, PA-C

  • Physician Assistant
  • Indianapolis, IN
National Provider Identifier
1740363001
Registry record updated Mar 6, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
10001368A Issued in IN
Practice address
5510 S East St
BLDG a, Suite B
Indianapolis, IN 46227-1938
Phone
(317) 735-1525
NPI assigned
Oct 23, 2006
Last updated
Mar 6, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2014

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 5601004453 MI
Physician Assistant 363A00000X 10001368A IN Primary

Addresses

Primary practice location

5510 S East St
BLDG a, Suite B
Indianapolis, IN 46227-1938

Mailing address

5510 S East St
BLDG a, Suite B
Indianapolis, IN 46227-1938
Phone (317) 735-1525

Other identifiers 1

IdentifierTypeStateIssuer
P01212112OtherINRR MEDICARE PTAN

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
I20220420002421 IN Order and Referring Only - Physician Assistant 9537323795

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
10001368AINMDPhysician Assistant
5601004453MIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Major Hospital Past Accepting new patients
Everside Health, LLC Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1394064000000",
    "number": "1740363001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5510 S EAST ST",
            "address_2": "BLDG A, SUITE B",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462271938",
            "telephone_number": "317-735-1525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5510 S EAST ST",
            "address_2": "BLDG A, SUITE B",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462271938",
            "telephone_number": "317-735-1525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WORMAN",
        "first_name": "JAMES",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-23",
        "last_updated": "2014-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601004453",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IN",
            "license": "10001368A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE PTAN",
            "identifier": "P01212112",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.