Brian Jellison (NPI# 1225016835, PAC ID# 9032194428) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is DIAGNOSTIC RADIOLOGY.
| Nation Provider ID (NPI) | 1225016835 |
| PAC ID by PECOS | 9032194428 |
| Professional Enrollment ID | I20060711000436 |
| Full Name | Brian Jellison |
| Organization Legal Name | NORTHWEST RADIOLOGIST PC |
| Address |
10603 N Meridian St Northwest Radiology Network Indianapolis IN 46290-1055 |
| Phone Number | 3179729669 |
| Gender | M |
| Credential | MD |
| Medical School | INDIANA UNIVERSITY SCHOOL OF MEDICINE |
| Graduation Year | 2000 |
| Primary Specialty | DIAGNOSTIC RADIOLOGY |
| Secondary Specialties | NEUROLOGY |
| Group Practice PAC ID | 1557331261 |
| Number of Group Practice Members | 57 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 150084 | ST. VINCENT HOSPITALS AND HEALTH SERVICES |
| 150059 | RIVERVIEW HEALTH |
| 150010 | ST. JOSEPH HOSPITAL & HEALTH CENTER, INC |
| 150088 | ST. VINCENT ANDERSON REGIONAL HOSPITAL |
| 150104 | WITHAM HEALTH SERVICES |
| Address | Phone | Organization |
|---|---|---|
| 10603 N Meridian St, Northwest Radiology Network, Indianapolis, IN 46290-1055 | 3179729669 | NORTHWEST RADIOLOGIST PC |
| 4880 Century Plaza Rd, Suite 200, Indianapolis, IN 46254-5474 | 3172934113 | AMERICAN HEALTH NETWORK OF INDIANA LLC |
| Measure Identifier | Measure Title | Performance Rate | Reporting Mechanism |
|---|---|---|---|
| MIPS_EC_195_overall | Radiology: Stenosis Measurement in Carotid Imaging Reports | 95% | |
| MIPS_EC_195_overall | Radiology: Stenosis Measurement in Carotid Imaging Reports | 95% | |
| MIPS_EC_436_overall | Radiation Consideration for Adult CT: Utilization of Dose Lowering Techniques | 1% | |
| MIPS_EC_436_overall | Radiation Consideration for Adult CT: Utilization of Dose Lowering Techniques | 1% |
| Organization Legal Name | NORTHWEST RADIOLOGIST PC |
| Physicians | 58 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Martha J Dwenger | Diagnostic Radiology | Northwest Radiologist PC | 1547 Ohio Ave, Anderson, IN 46016-1917 |
| Caryn C Anderson | Diagnostic Radiology | Northwest Radiologist PC | 2015 Jackson St, Anderson, IN 46016-4337 |
| Theodore P Labus | Diagnostic Radiology | Northwest Radiologist PC | 12188 N Meridian St, 101 Meridian North Imaging Center, Carmel, IN 46032-4578 |
| Matthew M. Locker | Diagnostic Radiology | Northwest Radiologist PC | 2015 Jackson St, Anderson, IN 46016-4337 |
| John M Michael | Diagnostic Radiology | Northwest Radiologist PC | 2015 Jackson St, Anderson, IN 46016-4337 |
| Jane S Mitchell | Diagnostic Radiology | Northwest Radiologist PC | 2015 Jackson St, Anderson, IN 46016-4337 |
| Theodore Bauer Jennermann | Diagnostic Radiology | Northwest Radiologist PC | 2015 Jackson St, Anderson, IN 46016-4337 |
| Matthew Robert Brown | Diagnostic Radiology | Northwest Radiologist PC | 2015 Jackson St, Anderson, IN 46016-4337 |
| Anthony Christopher Illing | Diagnostic Radiology | Northwest Radiologist PC | 2015 Jackson St, Anderson, IN 46016-4337 |
| Kelly K. Horst | Diagnostic Radiology | Northwest Radiologist PC | 2015 Jackson St, Anderson, IN 46016-4337 |
| Street Address |
10603 N MERIDIAN ST NORTHWEST RADIOLOGY NETWORK |
| City | INDIANAPOLIS |
| State | IN |
| Zip | 46290-1055 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Shashi Puttaswamy | Internal Medicine | St Vincent Medical Group Inc | 10603 N Meridian St, Indianapolis, IN 46290-1055 |
| Melissa Leann Humburg | Nurse Practitioner | St Vincent Medical Group Inc | 10603 N Meridian St, Suite 100, Indianapolis, IN 46290-1055 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Jennie S Kho Duffin | Pathology | Dcl Pathology LLC | 10291 N Meridian St, Suite 100, Indianapolis, IN 46290-1000 |
| Cynthia Carol Benedict | Pathology | Dcl Pathology LLC | 10291 N Meridian St, Suite 100, Indianapolis, IN 46290-1000 |
| Sally D Slowman Middleton | Pathology | Dcl Pathology LLC | 10291 N Meridian St, Suite 100, Indianapolis, IN 46290-1000 |
| Carol C Eisenhut | Pathology | Dcl Pathology LLC | 10291 N Meridian St, Indianapolis, IN 46290-1000 |
| Lori E Dressman | Pathology | Dcl Pathology LLC | 10291 N Meridian St, Indianapolis, IN 46290-1000 |
| Alan M Sadove | Plastic and Reconstructive Surgery | Perkins Van Natta Plastic Surgery, P.C. | 170 W 106th St, Indianapolis, IN 46290-1004 |
| Christine L Kelley Patteson | Plastic and Reconstructive Surgery | Perkins Van Natta Plastic Surgery, P.C. | 170 W 106th St, Indianapolis, IN 46290-1004 |
| Stephen W Perkins | Plastic and Reconstructive Surgery | Perkins Van Natta Plastic Surgery, P.C. | 170 W 106th St, Indianapolis, IN 46290-1004 |
| Bruce W Van Natta | Plastic and Reconstructive Surgery | Perkins Van Natta Plastic Surgery, P.C. | 170 W 106th St, Indianapolis, IN 46290-1004 |
| Richard Burgett | Ophthalmology | Ophthalmic Plastic Surgery Inc | 200 W 103rd St, Suite 2020, Indianapolis, IN 46290-1017 |
| Find all physicians in zip 46290 | |||
| City | INDIANAPOLIS |
| Zip Code | 46290 |
| Specialty | DIAGNOSTIC RADIOLOGY |
| City + Specialty | INDIANAPOLIS + DIAGNOSTIC RADIOLOGY |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.