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JAKE LEE MULLENBACH
NPI 1396440574
Student in an Organized Health Care Education/Training Program in Indianapolis, IN

Active since April 05, 2023PECOS Enrolled
1120 W MICHIGAN ST # CL630, INDIANAPOLIS, IN 46202(317) 278-2682 Get Directions Write a Review

NPPES record last updated: April 5, 2023. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Jake Lee Mullenbach NPPES

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

JAKE LEE MULLENBACH (NPI 1396440574) 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

NPI1396440574
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameJAKE LEE MULLENBACH
Location Address1120 W MICHIGAN ST # CL630Indianapolis, IN 46202-5209
Mailing Address1120 W Michigan St # Cl630Indianapolis, IN 46202-5209 · (317) 278-2682
Phone(317) 278-2682
Sole ProprietorNo
Enumeration DateApril 5, 2023
NPPES CertifiedApril 5, 2023
✔ NPI 1396440574 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.
1120 W MICHIGAN ST # CL630, 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)

Jake Lee Mullenbach 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.

MADISON OTT MD
Student in an Organized Health Care Education/Training Program
1120 W MICHIGAN ST # CL630
INDIANAPOLIS, IN 46202
Marion County (317) 278-2686
MICHAEL SAM ROSENHECK
Student in an Organized Health Care Education/Training Program
1120 W MICHIGAN ST # CL630
INDIANAPOLIS, IN 46202
Marion County (317) 278-2686
AARON CRAIG MINER MD
Anesthesiology
1120 W MICHIGAN ST # CL630
INDIANAPOLIS, IN 46202
Marion County (317) 278-2686
DR. JEFFREY FREIDENSON MD
Student in an Organized Health Care Education/Training Program
1120 W MICHIGAN ST # CL630
INDIANAPOLIS, IN 46202
Marion County (317) 278-2659
SAIISHITHA NALAMOLU DO
Student in an Organized Health Care Education/Training Program
1120 W MICHIGAN ST # CL630
INDIANAPOLIS, IN 46202
Marion County (317) 278-2686
MOHSIN MUKHTAR MD
Radiology (Diagnostic Radiology)
1120 W MICHIGAN ST # CL630
INDIANAPOLIS, IN 46202
Marion County (317) 278-2689
ERIC CHUNG MD
Anesthesiology
1120 W MICHIGAN ST # CL630
INDIANAPOLIS, IN 46202
Marion County (317) 278-2689
RUSSELL DYLAN PURPURA MD
Internal Medicine (Pulmonary Disease)
1120 W MICHIGAN ST # CL630
INDIANAPOLIS, IN 46202
Marion County (317) 278-2686

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 Jake Mullenbach's NPI number?

The NPI number for Jake Mullenbach is 1396440574. It was assigned to this individual provider in the NPPES registry on April 5, 2023.

Where is Jake Mullenbach located?

Jake Mullenbach practices at 1120 W Michigan St # Cl630, Indianapolis, IN 46202. The listed phone number is (317) 278-2682.

What is Jake Mullenbach's specialty?

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

Is Jake Mullenbach enrolled in Medicare?

Yes. Jake Mullenbach is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Jake Mullenbach was last updated on April 5, 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.