Individual provider Active NPI

Jackylin Caparas, M.D.

  • Internal Medicine Physician
  • Fort Wayne, IN
National Provider Identifier
1881991834
Registry record updated Oct 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
01070707A Issued in IN
Practice address
3909 New Vision Dr
Fort Wayne, IN 46845
Phone
(260) 469-6602
Fax
(260) 969-3065
NPI assigned
Feb 26, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X 01070707A IN
Internal Medicine Physician 207R00000X 01070707A IN Primary

Addresses

Primary practice location

3909 New Vision Dr
Fort Wayne, IN 46845

Mailing address

11109 Parkview Plaza Dr # 117
Fort Wayne, IN 46845-1701

Other identifiers 3

IdentifierTypeStateIssuer
ANTHEMOtherIN000000762410
P01074066OtherINR.R. MEDICARE
201057340MedicaidIN

Electronic endpoints 3

TypeEndpointUseAffiliation
Direct Messaging Address jsalvador11550@Direct.Parkviewexchange.com
FHIR URL https://epicprod-mobile.parkview.com/FHIR/api/FHIR/DSTU2/
FHIR URL https://epicprod-mobile.parkview.com/FHIR/api/FHIR/R4/

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
I20120521000226 IN Practitioner - Internal Medicine 3971766460 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Parkview Health System IncGroup PAC ID 2163336967, 1,350 clinicians

Practice addresses (Care Compare)

11109 Parkview Plaza Dr
Fort Wayne, IN 46845-1701
Phone (260) 425-6030

Hospital & facility affiliations

  • Parkview Regional Medical Center Hospital, Fort Wayne, IN, CCN 150021
  • Parkview Dekalb Hospital Hospital, Auburn, IN, CCN 150045
  • Dupont Hospital LLC Hospital, Fort Wayne, IN, CCN 150150
  • Cameron Health Hospital, Angola, IN, CCN 151315

Merit-based Incentive Payment System (MIPS)

Final score
83.53 of 100Reported as group
Quality
70
Promoting interoperability
100
Improvement activities
40
Cost
75.11

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01070707AINMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Parkview Health System Inc Internal Medicine Current Accepting new patients
Parkview Health System, Inc. Internal Medicine CurrentSince May 2, 2019 Accepting new patients

Locations

817 Trail Ridge Rd
Albion, IN 46701
Phone (260) 373-9590

306 E Maumee St
Angola, IN 46703
Phone (260) 667-5335

416 E Maumee St
Angola, IN 46703
Phone (260) 665-2141

3909 New Vision Dr
Fort Wayne, IN 46845
Phone (260) 373-8000

11109 Parkview Plaza Dr
#117
Fort Wayne, IN 46845
Phone (260) 266-6012

11109 Parkview Plaza Dr
Fort Wayne, IN 46845
Phone (260) 266-2020

3702 New Vision Dr
Bldg B
Fort Wayne, IN 46845
Phone (260) 266-8210

15333 Hunters Ridge Ln
Huntertown, IN 46748
Phone (260) 425-4870

240 S Jefferson St
Ste B
Huntington, IN 46750
Phone (219) 259-0000

512 Professional Way
Kendallville, IN 46755
Phone (260) 347-8556

Interoperability endpoints

  • Direct secure messaging: jsalvador11550@direct.parkviewexchange.com

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 and National Provider Directory roles.

Hospital & facility affiliations 4

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": "1298678400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666224000000",
    "number": "1881991834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11109 PARKVIEW PLAZA DR # 117",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468451701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3909 NEW VISION DR",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "46845",
            "telephone_number": "260-469-6602",
            "fax_number": "260-969-3065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAPARAS",
        "first_name": "JACKYLIN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-02-26",
        "last_updated": "2022-10-20",
        "certification_date": "2022-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "IN",
            "license": "01070707A",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IN",
            "license": "01070707A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "000000762410",
            "identifier": "ANTHEM",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "R.R. MEDICARE",
            "identifier": "P01074066",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201057340",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jsalvador11550@Direct.Parkviewexchange.com",
            "affiliation": "N",
            "address_1": "3909 New Vision Dr",
            "city": "Fort Wayne",
            "state": "IN",
            "country_code": "US",
            "postal_code": "46845",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicprod-mobile.parkview.com/FHIR/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "3909 New Vision Dr",
            "city": "Fort Wayne",
            "state": "IN",
            "country_code": "US",
            "postal_code": "46845",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicprod-mobile.parkview.com/FHIR/api/FHIR/R4/",
            "affiliation": "N",
            "address_1": "3909 New Vision Dr",
            "city": "Fort Wayne",
            "state": "IN",
            "country_code": "US",
            "postal_code": "46845",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

Verify at the official NPI Registry.