Individual provider Active NPI

Jason D Brown, PA

  • Physician Assistant
  • Indianapolis, IN
National Provider Identifier
1942269287
Registry record updated Feb 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
10000787A Issued in IN
Practice address
1801 N Senate Blvd
Ste 755
Indianapolis, IN 46202-1228
Phone
(317) 962-5888
NPI assigned
Mar 23, 2006
Last updated
Feb 15, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2022

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 99017012A IN
Physician Assistant 363A00000X 10000787A IN Primary

Addresses

Primary practice location

1801 N Senate Blvd
Ste 755
Indianapolis, IN 46202-1228

Mailing address

PO Box 781076
Detroit, MI 48278-1076

Other identifiers 3

IdentifierTypeStateIssuer
000000386766OtherINBCBS
Q0244502OtherINRRMC
066899OtherINSIHO

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jbrown197278@Direct.FranciscanAlliance.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
10000787AINMDPhysician Assistant
99017012AINMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Major Hospital Past Accepting new patients
CCSG LLC Physician Assistant Past Accepting new patients
University Medical Diagnostic Associates, Inc. Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: jbrown197278@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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1143072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644883200000",
    "number": "1942269287",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 N SENATE BLVD",
            "address_2": "STE 755",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462021228",
            "telephone_number": "317-962-5888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "JASON",
        "middle_name": "D",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-23",
        "last_updated": "2022-02-15",
        "certification_date": "2022-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IN",
            "license": "99017012A",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IN",
            "license": "10000787A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "000000386766",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RRMC",
            "identifier": "Q0244502",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SIHO",
            "identifier": "066899",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jbrown197278@Direct.FranciscanAlliance.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "5255 E Stop 11 Rd Ste 430",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "462376341",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.