Individual provider Active NPI

Jason D. Haviza, NP

  • Gerontology Nurse Practitioner
  • Indianapolis, IN
National Provider Identifier
1891346763
Registry record updated May 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
71009383A Issued in IN
Practice address
1801 N Senate Blvd Ste 2000
Indianapolis, IN 46202-1252
Phone
(317) 962-8700
Fax
(317) 962-9704
NPI assigned
Sep 23, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 22, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 71009383A IN
Gerontology Nurse Practitioner 363LG0600X 28216219A IN
Registered Nurse 163W00000X 28216219A IN
Gerontology Nurse Practitioner 363LG0600X 71009383A IN Primary

Addresses

Primary practice location

1801 N Senate Blvd Ste 2000
Indianapolis, IN 46202-1252

Mailing address

1801 N Senate Blvd Ste 2000
Indianapolis, IN 46202-1252
Phone (317) 962-8700

Other practice location 1

1701 N Senate Blvd
Indianapolis, IN 46202-1239
Phone (888) 484-3258

Other identifiers 1

IdentifierTypeStateIssuer
300030817MedicaidIN

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address jhaviza1@direct.iuhealth.org
Direct Messaging Address jhaviza1@direct.iuhealth.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
I20191025000343 IN Practitioner - Nurse Practitioner 2961734835 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Iu Health Medical Group LLCGroup PAC ID 9638617913, 4,382 clinicians

Practice addresses (Care Compare)

1701 N Senate Blvd
Indianapolis, IN 46202-1239
Phone (888) 484-3258

Hospital & facility affiliations

  • Indiana University Health North Hospital Hospital, Carmel, IN, CCN 150161
  • Indiana University Health Hospital, Indianapolis, IN, CCN 150056

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
28216219AINMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Iu Health Medical Group, LLC Family CurrentSince Jul 1, 2025 Accepting new patients
Indiana University Health Care Associates, Inc Family CurrentSince Nov 1, 2019 Accepting new patients
University Medical Diagnostic Associates, Inc. Past Accepting new patients
Major Hospital Past Accepting new patients

Locations

5208 Reliable Pkwy
Chicago, IL 60686

7230 Engle Rd
Ste 100
Fort Wayne, IN 46804
Phone (317) 620-0232

1801 Senate Blvd
Indianapolis, IN 46202
Phone (317) 929-8880

1701 Senate Blvd
Indianapolis, IN 46202
Phone (317) 612-2754

1801 Senate Blvd
Ste 2000
Indianapolis, IN 46202
Phone (317) 962-0500

4880 Century Plaza Rd
Ste 265
Indianapolis, IN 46254
Phone (317) 216-2700

8820 S Meridian St
Ste 230
Indianapolis, IN 46217
Phone (317) 865-6777

8820 S Meridian St
Indianapolis, IN 46217
Phone (317) 865-6700

8820 S Meridian St
Ste 200
Indianapolis, IN 46217
Phone (317) 865-6750

1701 N Senate Blvd
Bldg C6
Indianapolis, IN 46202
Phone (913) 962-2000

250 N Shadeland Ave
Indianapolis, IN 46219
Phone (317) 948-9174

Interoperability endpoints

  • Direct secure messaging: jhaviza1@direct.iuhealth.org

Organizations & group practices 4

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": "1569196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747872000000",
    "number": "1891346763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 N SENATE BLVD STE 2000",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462021252",
            "telephone_number": "317-962-8700",
            "fax_number": "317-962-9704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 N SENATE BLVD STE 2000",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462021252",
            "telephone_number": "317-962-8700",
            "fax_number": "317-962-9704"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1701 N Senate Blvd",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462021239",
            "country_code": "US",
            "telephone_number": "888-484-3258",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAVIZA",
        "first_name": "JASON",
        "middle_name": "D.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-09-23",
        "last_updated": "2025-05-22",
        "certification_date": "2025-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71009383A",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "IN",
            "license": "28216219A",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IN",
            "license": "28216219A",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "IN",
            "license": "71009383A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300030817",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jhaviza1@direct.iuhealth.org",
            "affiliation": "N",
            "address_1": "1801 N Senate Blvd Ste 2000",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "462021252",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jhaviza1@direct.iuhealth.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1701 N Senate Blvd",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "462021239",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.