Active NPI
Jacob M. Fraker, P.A.
- Physician Assistant
- South Bend, IN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 10000686A
- Practice address
- 53880 Carmichael Dr
South Bend, IN 46635-1567 - Phone
- (574) 247-9441
- Fax
- (574) 247-9442
- NPI assigned
- Nov 16, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 10000686A | IN | Primary |
Addresses
Primary practice location
53880 Carmichael Dr
South Bend, IN 46635-1567
Mailing address
3600 W Bethel Ave
Muncie, IN 47304-5407
Other practice location 1
60160 Bodnar Blvd
Mishawaka, IN 46544-9338
Phone (574) 247-9441
Other practice location 2
303 S Nappanee St Ste F
Elkhart, IN 46514-2066
Phone (574) 246-9441
Other practice location 3
2349 Lake Ave Ste 201
Plymouth, IN 46563-7837
Phone (574) 247-9441
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, 2002
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
3600 W Bethel Ave
Muncie, IN 47304-5407
Phone (765) 284-7738
53880 Carmichael Dr
South Bend, IN 46635-1567
Phone (317) 455-1064
60160 Bodnar Blvd
Mishawaka, IN 46544-9338
Phone (574) 247-9441
Hospital & facility affiliations
- Saint Joseph Regional Medical Center
- Unity Physicians Hospital
- Saint Joseph Regional Medical Center - Plymouth
Merit-based Incentive Payment System (MIPS)
- Final score
- 81.81 of 100
- Quality
- 64.48
- Promoting interoperability
- 96
- Improvement activities
- 40
- Cost
- 78.21
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Central Indiana Orthopedics, LLC | Current | Accepting new patients | |
| Central Indiana Orthopedics, LLC | Current | Accepting new patients | |
| Central Indiana Orthopedics LLC | Past | Accepting new patients |
Locations
303 S Nappanee St
Ste F
Elkhart, IN 46514
Phone (547) 247-9441
900 I St
Laporte, IN 46350
Phone (219) 324-1670
60160 Bodnar Blvd
Mishawaka, IN 46544
Phone (574) 247-2790
3600 W Bethel Ave
Muncie, IN 47304
Phone (765) 213-3870
2349 Lake Ave
Ste 201
Plymouth, IN 46563
Phone (574) 540-2500
53880 Carmichael Dr
South Bend, IN 46635
Phone (574) 234-1159
Interoperability endpoints
- jfraker1158578@direct.trinity-health.org
- jacob.fraker.3@13070.direct.athenahealth.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.
-
- Orthopaedic Surgery Physician
- Muncie, IN
- NPI 1063422137
-
- Orthopaedic Surgery Physician
- Anderson, IN
- NPI 1578678751
-
- Orthopaedic Surgery Physician
- Indianapolis, IN
- NPI 1669207023
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Plymouth, IN
- NPI 1174571129
-
- General Acute Care Hospital
- Mishawaka, IN
- NPI 1023965795
-
- General Acute Care Hospital
- Mishawaka, IN
- NPI 1841245594
-
- General Acute Care Hospital
- Mishawaka, IN
- NPI 1518197011
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1132099200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1725321600000",
"number": "1770565723",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3600 W BETHEL AVE",
"city": "MUNCIE",
"state": "IN",
"postal_code": "473045407"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "53880 CARMICHAEL DR",
"city": "SOUTH BEND",
"state": "IN",
"postal_code": "466351567",
"telephone_number": "574-247-9441",
"fax_number": "574-247-9442"
}
],
"practiceLocations": [
{
"address_1": "60160 Bodnar Blvd",
"address_purpose": "LOCATION",
"city": "Mishawaka",
"state": "IN",
"postal_code": "465449338",
"country_code": "US",
"telephone_number": "574-247-9441",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "303 S Nappanee St Ste F",
"address_purpose": "LOCATION",
"city": "Elkhart",
"state": "IN",
"postal_code": "465142066",
"country_code": "US",
"telephone_number": "574-246-9441",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "2349 Lake Ave Ste 201",
"address_purpose": "LOCATION",
"city": "Plymouth",
"state": "IN",
"postal_code": "465637837",
"country_code": "US",
"telephone_number": "574-247-9441",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "FRAKER",
"first_name": "JACOB",
"middle_name": "M.",
"name_prefix": "Mr.",
"credential": "P.A.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-11-16",
"last_updated": "2024-09-03",
"certification_date": "2024-09-03",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "IN",
"license": "10000686A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in South Bend, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2024; 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.