Individual provider Active NPI

Oksana P Jumanov

  • Nurse Practitioner
  • Goshen, IN
National Provider Identifier
1972477271
Registry record updated Oct 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
28234307A Issued in IN
Practice address
1808 Charlton CT
Goshen, IN 46526-6463
Phone
(574) 533-8420
NPI assigned
Oct 1, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 28234307A IN Primary

Addresses

Primary practice location

1808 Charlton CT
Goshen, IN 46526-6463

Mailing address

10191 Forest Lakes Dr
Middlebury, IN 46540-9430

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
I20251112003758 IN Practitioner - Nurse Practitioner 7618468133 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Goshen Health System IncGroup PAC ID 4880598572, 135 clinicians

Practice addresses (Care Compare)

1808 Charlton CT
Goshen, IN 46526-6463
Phone (574) 537-0219

Hospital & facility affiliations

  • Goshen Hospital Hospital, Goshen, IN, CCN 150026

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
28234307AINMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Goshen Health System Inc CurrentSince Nov 6, 2025 Accepting new patients
Goshen Health System Inc Nurse Practitioner CurrentSince Nov 6, 2025 Accepting new patients

Locations

1808 Charlton Ct
Goshen, IN 46526
Phone (574) 533-8420

2824 Elkhart Rd
Goshen, IN 46526
Phone (574) 534-6752

200 High Park Ave
Goshen, IN 46526
Phone (219) 533-2141

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 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": "1759276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759276800000",
    "number": "1972477271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10191 FOREST LAKES DR",
            "city": "MIDDLEBURY",
            "state": "IN",
            "postal_code": "465409430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1808 CHARLTON CT",
            "city": "GOSHEN",
            "state": "IN",
            "postal_code": "465266463",
            "telephone_number": "574-533-8420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUMANOV",
        "first_name": "OKSANA",
        "middle_name": "P",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-10-01",
        "last_updated": "2025-10-01",
        "certification_date": "2025-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IN",
            "license": "28234307A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Goshen, IN

Sources for this page

Verify at the official NPI Registry.