Individual provider Active NPI

Jacqueline L. Graber, M.D.

  • Anesthesiology Physician
  • Indianapolis, IN
National Provider Identifier
1952396079
Registry record updated Aug 27, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
01048921A Issued in IN
Practice address
8040 Clearvista Pkwy
Indianapolis, IN 46256-5630
Phone
(317) 567-2179
Fax
(317) 567-2191
NPI assigned
Sep 14, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 01048921A IN Primary

Addresses

Primary practice location

8040 Clearvista Pkwy
Indianapolis, IN 46256-5630

Mailing address

PO Box 6005
Dept 196
Indianapolis, IN 46206-6005
Phone (317) 567-2180

Other identifiers 1

IdentifierTypeStateIssuer
200329810MedicaidIN

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
I20050204000385 IN Practitioner - Anesthesiology 3971554163 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Indiana University School of Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bloomington Anesthesiologists PCGroup PAC ID 6204740988, 39 clinicians
Aas Indiana LLCGroup PAC ID 4688045115, 43 clinicians

Practice addresses (Care Compare)

2651 E Discovery Pkwy
Bloomington, IN 47408-9059
Phone (812) 353-9147

4105 Dicke Rd
Fort Wayne, IN 46804-6135
Phone (260) 268-1000

Hospital & facility affiliations

  • Indiana University Health Bloomington Hospital Hospital, Bloomington, IN, CCN 150051

Merit-based Incentive Payment System (MIPS)

Final score
67.76 of 100Reported as group
Quality
62.07
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Bloomington Anesthesiologists PC Anesthesiology CurrentSince Dec 1, 2022 Accepting new patients
Aas Indiana LLC Anesthesiology CurrentSince Jul 1, 2024 Accepting new patients
Daviess County Hospital CurrentSince Jan 1, 2011 Accepting new patients
Daviess County Hospital CurrentSince Jan 1, 2011 Accepting new patients
Associated Anesthesiologists of Fort Wayne PC Anesthesiology CurrentSince Nov 15, 2018 Accepting new patients
Daviess County Hospital Current Accepting new patients
Riverview Anesthesiologists, PC Anesthesiology PastSince Jun 18, 2023 Accepting new patients

Locations

1316 E 7th St
Auburn, IN 46706
Phone (260) 925-4600

2651 E Discovery Pkwy
Bloomington, IN 47408
Phone (812) 353-9147

10300 N Illinois St
Ste 1300
Carmel, IN 46290
Phone (317) 688-3690

6435 W Jefferson Blvd
Fort Wayne, IN 46804
Phone (260) 436-7875

4105 Dicke Rd
Fort Wayne, IN 46804
Phone (260) 268-1000

2520 E DuPont Rd
Fort Wayne, IN 46825
Phone (219) 407-8000

10315 Dawsons Creek Blvd
Ste Ab
Fort Wayne, IN 46825
Phone (219) 436-7875

5734 Coventry Ln
Fort Wayne, IN 46804
Phone (219) 436-7875

2401 W University Ave
Muncie, IN 47303
Phone (765) 747-3111

2101 Dubois Dr
Warsaw, IN 46580
Phone (219) 267-3200

1314 E Walnut St
Washington, IN 47501
Phone (812) 254-2250

Organizations & group practices 7

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 1

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": "1126656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1251331200000",
    "number": "1952396079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6005",
            "address_2": "DEPT 196",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462066005",
            "telephone_number": "317-567-2180",
            "fax_number": "317-567-2191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8040 CLEARVISTA PKWY",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462565630",
            "telephone_number": "317-567-2179",
            "fax_number": "317-567-2191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRABER",
        "first_name": "JACQUELINE",
        "middle_name": "L.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-14",
        "last_updated": "2009-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IN",
            "license": "01048921A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200329810",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.