Individual provider Active NPI

Mary Anna Jansen, M.D.

  • Family Medicine Physician
  • Aurora, IN
National Provider Identifier
1972890481
Registry record updated Nov 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
01073032A Issued in IN
Practice address
112 Links Way
Aurora, IN 47001-1403
Phone
(812) 926-3133
Fax
(812) 926-1668
NPI assigned
Jul 5, 2011
Last updated
Nov 21, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 01073032A IN Primary
Family Medicine Physician 207Q00000X R2501 KY

Addresses

Primary practice location

112 Links Way
Aurora, IN 47001-1403

Mailing address

PO Box 635283
Cincinnati, OH 45263-5283
Phone (812) 926-3133

Other identifiers 1

IdentifierTypeStateIssuer
201185890MedicaidIN

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
I20131118000395 IN Practitioner - Family Practice 8628204807 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Summit Medical Group IncGroup PAC ID 2163326240, 803 clinicians

Practice addresses (Care Compare)

112 Links Way
St. Elizabeth Physicians
Aurora, IN 47001-1403
Phone (812) 926-3133

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.01 of 100Reported as apm
Quality
86.02
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R2501KYMDFamily Medicine Physician
01073032AINMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Summit Medical Group, Inc Family Medicine Current Accepting new patients

Locations

2300 Chamber Center Dr
Ste 200
Lakeside Park, KY 41017
Phone (859) 212-0039

Interoperability endpoints

  • Direct secure messaging: mjansen153136@direct-prd.stelizabeth.com

Organizations & group practices 1

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": "1309824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763683200000",
    "number": "1972890481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 635283",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452635283",
            "telephone_number": "812-926-3133",
            "fax_number": "812-926-1668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 LINKS WAY",
            "city": "AURORA",
            "state": "IN",
            "postal_code": "470011403",
            "telephone_number": "812-926-3133",
            "fax_number": "812-926-1668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JANSEN",
        "first_name": "MARY",
        "middle_name": "ANNA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-05",
        "last_updated": "2025-11-21",
        "certification_date": "2025-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01073032A",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KY",
            "license": "R2501",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201185890",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Aurora, IN

Sources for this page

Verify at the official NPI Registry.