JACKIE SUZANNE TANK PA
NPI 1043854409
Physician Assistant in Indianapolis, IN

Q: What is Jackie Tank's NPI number?

The NPI number for Jackie Tank is 1043854409. It was assigned to this individual provider in the NPPES registry on October 29, 2019. The provider is also known as Jackie Reuther PA.

Q: What is Jackie Tank's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Q: When was this NPI record last updated?

The NPPES record for Jackie Tank was last updated on May 5, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since October 29, 2019PECOS EnrolledAccepts Medicare Assignment

5255 E STOP 11 RD STE 450, INDIANAPOLIS, IN 46237(317) 865-4800(317) 865-4806 Get Directions Write a Review

NPPES record last updated: May 5, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: May 5, 2026, Nov 18, 2024, Aug 22, 2023 and 3 more (6 updates tracked since 2019).

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About Jackie Suzanne Tank Pa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JACKIE SUZANNE TANK PA (NPI 1043854409) is an individual physician assistant in Indianapolis, Indiana, licensed in Indiana (10002853A) and active in the NPI registry since October 2019. She is enrolled in Medicare PECOS, maintains 2 additional practice locations, and is a graduate of Other (2019).

NPPES Registry Identity

NPI1043854409

Entity TypeIndividualFemale

Primary Taxonomy363A00000X

Provider Legal NameJACKIE SUZANNE TANKCredential: PA

Location Address5255 E STOP 11 RD STE 450Indianapolis, IN 46237-6342

Mailing AddressPo Box 781076Detroit, MI 48278-1076 · (317) 528-4800 · Fax (317) 865-1479

Phone(317) 865-4800

Fax(317) 865-4806

Sole ProprietorNo

Medical School CMSOtherGraduated 2019

Enumeration DateOctober 29, 2019

Last NPPES UpdateMay 5, 20266 updates tracked since enumeration

NPPES CertifiedMay 5, 2026

✔ NPI 1043854409 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363A00000X

License✔ Licensed in IN · 10002853A

Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

5255 E STOP 11 RD STE 450, Indianapolis, IN 46237

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Other Names 1

Former Name (1)Jackie Reuther Pa

Secondary Practice Locations 2

Location 1825 Chalkstone AveProvidence, RI 02908-4728 · Phone (401) 456-2000

Location 2200 High Service AveNorth Providence, RI 02904-5113 · Phone (401) 456-3000

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include CareSource.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Jackie Suzanne Tank Pa is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID6901234269

PECOS Enrollment IDI20200319001832

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 2

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

20 services20 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

16 services16 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 46237 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$82.04 typical visit price

range $53.07 – $161.76

Typical copayment $20.51 (range $13.26 – $40.44)

Most-billed visit code 99203

Established Patient

$66.48 typical visit price

range $16.93 – $132.22

Typical copayment $16.62 (range $4.23 – $33.05)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KYLE NORRIS SEUDEAL MD

Surgery