NPIMap

Organization Active NPI

P E T Imaging Services LLC

Doing business as P.E.T. Fusion

  • Diagnostic Radiology Physician
  • Fort Wayne, IN
National Provider Identifier
1992768691
Registry record updated Sep 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
P E T IMAGING SERVICES LLC
Doing business as
P.E.T. Fusion
Practice address
3707 New Vision Dr
Fort Wayne, IN 46845
Phone
(260) 469-4738
Fax
(260) 484-5919
NPI assigned
Apr 11, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2026

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

Authorized official

Name
Meredith Jacobs
Title
Ceo
Phone
(260) 469-4752

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2085R0202X Primary

Addresses

Primary practice location

3707 New Vision Dr
Fort Wayne, IN 46845

Mailing address

3707 New Vision Dr
Fort Wayne, IN 46845-1702
Phone (260) 469-4738

Other identifiers 1

IdentifierTypeStateIssuer
200384070AMedicaidIN

Other names 1

  • P.E.T. Fusion Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050506000346 IN Part B Supplier - Clinic/Group Practice 2668412842 Receives reassigned benefits from 33 practitioners
Practice locations: Indianapolis, IN; Fort Wayne, IN

National Provider Directory

National Provider Directory

Member of 2

Organizations this organization is a member of, according to the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 38

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 38

NPI Registry JSON

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

{
    "created_epoch": "1144713600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1790035200000",
    "number": "1992768691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3707 NEW VISION DR",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468451702",
            "telephone_number": "260-469-4738",
            "fax_number": "260-484-5919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3707 NEW VISION DR",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "46845",
            "telephone_number": "260-469-4738",
            "fax_number": "260-484-5919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "P E T IMAGING SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-11",
        "last_updated": "2026-09-22",
        "certification_date": "2026-09-22",
        "status": "A",
        "authorized_official_last_name": "JACOBS",
        "authorized_official_first_name": "MEREDITH",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "260-469-4752"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200384070A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "P.E.T. Fusion",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fort Wayne, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.