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JEFFERSON PARK PEDIATRICS P C
NPI 1629263181
Pediatrics in Fort Wayne, IN

Active since September 07, 2007
3919 W JEFFERSON BLVD STE 1, FORT WAYNE, IN 46804(260) 436-7722(260) 459-0012 Get Directions Write a Review

NPPES record last updated: April 23, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Jefferson Park Pediatrics P C NPPES

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

JEFFERSON PARK PEDIATRICS P C (NPI 1629263181) is a healthcare organization registered as a pediatrics in Fort Wayne, Indiana and active in the NPI registry since September 2007. The organization maintains a secondary practice location in Fort Wayne and lists Giridhar Rao Veerula, Owner, as its authorized official.

NPPES Registry Identity

NPI1629263181
Entity TypeOrganization
Primary Taxonomy208000000X
Legal Business NameJEFFERSON PARK PEDIATRICS P C
Location Address3919 W JEFFERSON BLVD STE 1Fort Wayne, IN 46804-6811
Mailing Address3919 W Jefferson Blvd Ste 1Fort Wayne, IN 46804-6811 · (260) 436-7722 · Fax (260) 459-0012
Phone(260) 436-7722
Fax(260) 459-0012
Organization SubpartNo
Authorized OfficialGiridhar Rao VeerulaOwner · (260) 436-7722
Enumeration DateSeptember 7, 2007
Last NPPES UpdateApril 23, 2025
NPPES CertifiedApril 23, 2025
✔ NPI 1629263181 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 5

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
Definition
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
Also ListedSpecialistTaxonomy 174400000X
Also ListedIntegrative MedicineTaxonomy 202D00000X
Also ListedDermatologyTaxonomy 207N00000X
Also ListedFamily MedicineTaxonomy 207Q00000X
3919 W JEFFERSON BLVD STE 1, Fort Wayne, IN 46804
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Secondary Practice Location 1

Location 13919 W Jefferson Blvd Ste 2Fort Wayne, IN 46804-6811 · Phone (260) 450-1313 · Fax (260) 436-7722

Other Identifiers 1

Medicaid200262620IN

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.Insurance ›

Other Providers at the Same Location NPPES

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

VIJAY VEERULA DO
Family Medicine
3919 W JEFFERSON BLVD STE 1
FORT WAYNE, IN 46804
Allen County (260) 436-7722

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 Jefferson Park Pediatrics P C's NPI number?

The NPI number for Jefferson Park Pediatrics P C is 1629263181. It was assigned to this organization in the NPPES registry on September 7, 2007.

Where is Jefferson Park Pediatrics P C located?

Jefferson Park Pediatrics P C is located at 3919 W Jefferson Blvd Ste 1, Fort Wayne, IN 46804. The listed phone number is (260) 436-7722.

What is Jefferson Park Pediatrics P C's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

What insurance does Jefferson Park Pediatrics P C accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian and CareSource list Jefferson Park Pediatrics P C as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Jefferson Park Pediatrics P C was last updated on April 23, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.