Individual provider Active NPI

Julie Podell Lena, PA-C

  • Physician Assistant
  • North Judson, IN
National Provider Identifier
1942569348
Registry record updated Jun 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0110003816
Practice address
414 Lane Street
North Judson, IN 46366-3212
Phone
(574) 896-4325
NPI assigned
May 7, 2012
Last updated
Jun 26, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0110003816 Primary

Addresses

Primary practice location

414 Lane Street
North Judson, IN 46366-3212

Mailing address

PO Box 279
Winamac, IN 46996-0279
Phone (574) 946-2147

Other practice location 1

602 Brandon Ave SW
Roanoke, VA 24015-3212
Phone (540) 774-0000

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
I20230623001985 IN Practitioner - Physician Assistant 7719106640 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pulaski Memorial HospitalGroup PAC ID 3173515509, 45 clinicians

Practice addresses (Care Compare)

414 Lane St
North Judson, IN 46366-1226
Phone (574) 896-4325

540 Hospital Dr
Winamac, IN 46996-1173
Phone (574) 946-2194

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science, Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Pulaski Memorial Hospital CurrentSince Jul 10, 2023 Accepting new patients
Pulaski Memorial Hospital CurrentSince Jul 10, 2023 Accepting new patients
Blue Ridge Healthcare Partners, LLC Past Accepting new patients

Locations

232 S Main St
Ste A
Culver, IN 46511
Phone (574) 335-7780

2 S Pearl St
Knox, IN 46534
Phone (574) 207-5050

414 Lane St
North Judson, IN 46366
Phone (574) 896-2257

540 Hospital Dr
Winamac, IN 46996
Phone (574) 935-4327

616 E 13th St
Winamac, IN 46996
Phone (574) 946-2100

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

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": "1336348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687737600000",
    "number": "1942569348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 279",
            "city": "WINAMAC",
            "state": "IN",
            "postal_code": "469960279",
            "telephone_number": "574-946-2147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "414 LANE STREET",
            "city": "NORTH JUDSON",
            "state": "IN",
            "postal_code": "463663212",
            "telephone_number": "574-896-4325"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "602 Brandon Ave SW",
            "address_purpose": "LOCATION",
            "city": "Roanoke",
            "state": "VA",
            "postal_code": "240153212",
            "country_code": "US",
            "telephone_number": "540-774-0000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LENA",
        "first_name": "JULIE",
        "middle_name": "PODELL",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-07",
        "last_updated": "2023-06-26",
        "certification_date": "2023-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": "0110003816",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Judson, IN

Sources for this page

Verify at the official NPI Registry.