Individual provider Active NPI

Joel Jaeger, DO

  • Sports Medicine (Family Medicine) Physician
  • Shelbyville, IN
National Provider Identifier
1740692078
Registry record updated Apr 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X
License
02005064A Issued in IN
Practice address
275 W Bassett Rd Ste 3
Shelbyville, IN 46176-8575
Phone
(317) 421-3265
NPI assigned
May 21, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Family Medicine) Physician 207QS0010X 02005064A IN Primary

Addresses

Primary practice location

275 W Bassett Rd Ste 3
Shelbyville, IN 46176-8575

Mailing address

275 W Bassett Rd Ste 3
Shelbyville, IN 46176-8575
Phone (317) 421-3265

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180719000119 IN Practitioner - Family Practice 9638499049 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Major Multispecialty AssociatesGroup PAC ID 6305997842, 39 clinicians

Practice addresses (Care Compare)

275 W Bassett Rd
3 MHP Sports Medicine
Shelbyville, IN 46176-8575
Phone (317) 421-3265

Hospital & facility affiliations

  • Suburban Home Health LLC Home health agency, Noblesville, IN, CCN 157092
  • Major Hospital Hospital, Shelbyville, IN, CCN 150097

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
02005064AINMDSports Medicine (Family Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Major Multispecialty Associates CurrentSince Aug 1, 2018 Accepting new patients
Major Multispecialty Associates Sports Medicine CurrentSince Aug 1, 2018 Accepting new patients
Major Hospital Past Accepting new patients

Locations

275 W Bassett Rd
Ste 3
Shelbyville, IN 46176
Phone (317) 421-3265

2451 Intelliplex Dr
#210
Shelbyville, IN 46176
Phone (317) 421-1914

30 W Rampart St
Ste 200
Shelbyville, IN 46176
Phone (317) 398-0121

275 W Bassett Rd
Shelbyville, IN 46176
Phone (317) 392-2161

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 2

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": "1400630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554854400000",
    "number": "1740692078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "275 W BASSETT RD STE 3",
            "city": "SHELBYVILLE",
            "state": "IN",
            "postal_code": "461768575",
            "telephone_number": "317-421-3265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "275 W BASSETT RD STE 3",
            "city": "SHELBYVILLE",
            "state": "IN",
            "postal_code": "461768575",
            "telephone_number": "317-421-3265"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAEGER",
        "first_name": "JOEL",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-05-21",
        "last_updated": "2019-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "IN",
            "license": "02005064A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shelbyville, IN

Sources for this page

Verify at the official NPI Registry.