JEFFERSON PARK PEDIATRICS P C
NPI 1629263181
Pediatrics in Fort Wayne, IN
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
Specialties & Licenses 5
Secondary Practice Location 1
Other Identifiers 1
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Jefferson Park Pediatrics P C is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
5Medicare enrollment records show 5 clinicians reassign Medicare billing to Jefferson Park Pediatrics P C, which bills Medicare for the services they deliver. Of these, 3 practice at this address and 4 within 10 miles. They are listed nearest first.
Clinicians, nearest first (5)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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.
Is Jefferson Park Pediatrics P C enrolled in Medicare?
Yes. Jefferson Park Pediatrics P C is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Jefferson Park Pediatrics P C?
According to the CMS Revalidation Reassignment List (October 2026 release), 5 clinicians in 3 Medicare specialties reassign their Medicare billing to Jefferson Park Pediatrics P C. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Nurse Practitioner (3), Dermatology (1) and Family Practice (1). Of these, 3 practice at this address and 4 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
What insurance does Jefferson Park Pediatrics P C accept?
Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Anthem Blue Cross and Blue Shield 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 18 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.
# Jefferson Park Pediatrics P C · NPI 1629263181
Pediatrics organization in Fort Wayne, Indiana. Organization record, active in the CMS NPPES registry since September 7, 2007.
## Identity
- **NPI:** 1629263181 (Entity type: Organization)
- **Enumerated:** September 7, 2007
- **Primary specialty:** Pediatrics · taxonomy 208000000X
- **Organization subpart:** No
- **Authorized official:** Giridhar Veerula, OWNER
## Practice location
- **Address:** 3919 W JEFFERSON BLVD STE 1, Fort Wayne, IN 46804-6811
- **Phone:** (260) 436-7722 · **Fax:** (260) 459-0012
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 5 clinicians in 3 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Nurse Practitioner (3), Dermatology (1), Family Practice (1); 3 practice at this address and 4 within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** April 23, 2025
- **Other identifiers:** Medicaid 200262620 (IN)
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Source: [NPI Profile](https://npiprofile.com/npi/1629263181) · Data from the CMS NPPES public registry.