Jefferson Park Pediatrics P C
NPI 1629263181ActiveOrganization· Pediatrics· Fort Wayne, IN
Pediatrics in Fort Wayne, Indiana, registered in NPPES in September 2007. The authorized official on file is Giridhar Rao Veerula, MD, Owner. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1629263181 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Sep 7, 2007 |
| Last updated in NPPES | Apr 23, 2025 |
| Certified by provider | Apr 23, 2025 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Pediatrics Primary | 208000000X | — | — |
| Specialist | 174400000X | — | — |
| Integrative Medicine | 202D00000X | — | — |
| Dermatology | 207N00000X | — | — |
| Family Medicine | 207Q00000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (IN) |
|---|
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