Individual provider Active NPI

Jill M. Reisman, PA

  • Medical Physician Assistant
  • Lafayette, IN
National Provider Identifier
1881617538
Registry record updated Jan 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
10000734A Issued in IN
Practice address
3900 St Francis Way Ste 200
Lafayette, IN 47905-4940
Phone
(765) 502-4000
Fax
(765) 402-4709
NPI assigned
Jul 25, 2006
Last updated
Jan 8, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2026

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 10000734A IN
Medical Physician Assistant 363AM0700X 10000734A IN Primary

Addresses

Primary practice location

3900 St Francis Way Ste 200
Lafayette, IN 47905-4940

Mailing address

PO Box 781076
Detroit, MI 48278-1076
Phone (317) 528-4800

Other practice location 1

1701 S Creasy Ln
Lafayette, IN 47905-4972
Phone (765) 502-4000

Other identifiers 1

IdentifierTypeStateIssuer
300008925MedicaidIN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jreisman5533@Direct.FranciscanAlliance.org Direct

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
I20050202000171 IN Practitioner - Physician Assistant 2365493863 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Franciscan Physician NetworkGroup PAC ID 3072790682, 1,152 clinicians

Practice addresses (Care Compare)

150 W Washington St
Shelbyville, IN 46176-1236
Phone (317) 865-5904

1701 S Creasy Lane
Lafayette, IN 47905-4972
Phone (765) 502-4000

1701 S Creasy LN
Lafayette, IN 47905-4972

3900 St Francis Way
Suite 201
Lafayette, IN 47905-4925
Phone (765) 428-1610

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
10000734AINMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Cardiac Surgery Associates SC CurrentSince Jan 1, 2022 Accepting new patients
Franciscan Physician Network CurrentSince Oct 9, 2012 Accepting new patients
Franciscan Physician Network Past Accepting new patients

Locations

1704 Lafayette Rd
Ste 4
Crawfordsvlle, IN 47933
Phone (765) 364-3120

1701 S Creasy Ln
Lafayette, IN 47905
Phone (765) 502-4400

3875 Kensington Dr
Lafayette, IN 47905
Phone (765) 449-1555

3900 St Francis Way
Ste 200
Lafayette, IN 47905
Phone (765) 775-2800

3920 St Francis Way
Ste 220
Lafayette, IN 47905
Phone (765) 428-5950

826 N 6th St
Monticello, IN 47960
Phone (574) 583-1924

801 MacArthur Blvd
Ste 204
Munster, IN 46321
Phone (219) 836-4220

150 W Washington St
Shelbyville, IN 46176
Phone (317) 392-3211

Interoperability endpoints

  • Direct secure messaging: jreisman5533@direct.franciscanalliance.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767830400000",
    "number": "1881617538",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 781076",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482781076",
            "telephone_number": "317-528-4800",
            "fax_number": "317-865-1479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3900 ST FRANCIS WAY STE 200",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479054940",
            "telephone_number": "765-502-4000",
            "fax_number": "765-402-4709"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1701 S Creasy Ln",
            "address_purpose": "LOCATION",
            "city": "Lafayette",
            "state": "IN",
            "postal_code": "479054972",
            "country_code": "US",
            "telephone_number": "765-502-4000",
            "fax_number": "765-502-4709",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REISMAN",
        "first_name": "JILL",
        "middle_name": "M.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-25",
        "last_updated": "2026-01-08",
        "certification_date": "2026-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IN",
            "license": "10000734A",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "IN",
            "license": "10000734A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300008925",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jreisman5533@Direct.FranciscanAlliance.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "3920 St Francis Way Ste 220",
            "city": "Lafayette",
            "state": "IN",
            "country_code": "US",
            "postal_code": "479054922",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lafayette, IN

Sources for this page

Verify at the official NPI Registry.