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CALEB JAMES NISSEN MD
NPI 1205522703
Student in an Organized Health Care Education/Training Program in Indianapolis, IN

Active since April 17, 2023PECOS Enrolled
355 W 16TH ST STE 2364, INDIANAPOLIS, IN 46202(317) 963-7307 Get Directions Write a Review

NPPES record last updated: April 17, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Caleb James Nissen Md NPPES

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

CALEB JAMES NISSEN MD (NPI 1205522703) is an individual student in an organized health care education/training program in Indianapolis, Indiana and active in the NPI registry since April 2023. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1205522703
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameCALEB JAMES NISSENCredential: MD
Location Address355 W 16TH ST STE 2364Indianapolis, IN 46202-2279
Mailing Address355 W 16th St Ste 2364Indianapolis, IN 46202-2279 · (317) 963-7307
Phone(317) 963-7307
Sole ProprietorNo
Enumeration DateApril 17, 2023
NPPES CertifiedApril 17, 2023
✔ NPI 1205522703 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
355 W 16TH ST STE 2364, Indianapolis, IN 46202
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Caleb James Nissen Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

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.

MS. AMANDA ROSEMARIE KAMINSKI
Student in an Organized Health Care Education/Training Program
355 W 16TH ST STE 2364
INDIANAPOLIS, IN 46202
Marion County (317) 963-7307
LAUREN OLIVIA BRYANT MD
Student in an Organized Health Care Education/Training Program
355 W 16TH ST STE 2364
INDIANAPOLIS, IN 46202
Marion County (317) 963-7307
JENNIFER MARIE MARTYNOWICZ
Psychiatry & Neurology (Psychiatry)
355 W 16TH ST STE 2364
INDIANAPOLIS, IN 46202
Marion County (317) 963-7288
JOSEPH MCCANN MD
Student in an Organized Health Care Education/Training Program
355 W 16TH ST STE 2364
INDIANAPOLIS, IN 46202
Marion County (317) 963-7307
MICAH SHIGENORI ITICOVICI MD
Student in an Organized Health Care Education/Training Program
355 W 16TH ST STE 2364
INDIANAPOLIS, IN 46202
Marion County (317) 963-7288
MICHAEL WEBER
Student in an Organized Health Care Education/Training Program
355 W 16TH ST STE 2364
INDIANAPOLIS, IN 46202
Marion County (317) 963-7307
MICHAEL BRIDGES
Psychiatry & Neurology (Psychiatry)
355 W 16TH ST STE 2364
INDIANAPOLIS, IN 46202
Marion County (317) 963-7307
SAMUEL DAVID GARRISON MD
Student in an Organized Health Care Education/Training Program
355 W 16TH ST STE 2364
INDIANAPOLIS, IN 46202
Marion County (317) 963-7307

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Caleb Nissen's NPI number?

The NPI number for Caleb Nissen is 1205522703. It was assigned to this individual provider in the NPPES registry on April 17, 2023.

Where is Caleb Nissen located?

Caleb Nissen practices at 355 W 16th St Ste 2364, Indianapolis, IN 46202. The listed phone number is (317) 963-7307.

What is Caleb Nissen's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Caleb Nissen enrolled in Medicare?

Yes. Caleb Nissen is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Caleb Nissen was last updated on April 17, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years 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.