Jefferson Park Pediatrics P C
NPI 1629263181 · Pediatrics Physician · Fort Wayne, IN
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Jefferson Park Pediatrics P C is a Pediatrics Physician organization in Fort Wayne, IN (NPI 1629263181).
Provider details
- NPI number
- 1629263181
- Entity type
- Organization
- Primary specialty
- Pediatrics PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Giridhar Veerula, Owner(260) 436-7722
Specialties & taxonomies
Allopathic & Osteopathic Physicians
- Specialist174400000X
Other Service Providers
- Integrative Medicine Physician202D00000X
Allopathic & Osteopathic Physicians
- Dermatology Physician207N00000X
Allopathic & Osteopathic Physicians
- Family Medicine Physician207Q00000X
Allopathic & Osteopathic Physicians
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
2 documented practice locations
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Additional practice locations (1)
- 3919 W Jefferson Blvd Ste 2Fort Wayne, IN 46804-6811Phone: (260) 450-1313Fax: (260) 436-7722
Registry dates
- Enumerated
- 2007-09-07
- Last updated
- 2025-04-23
- Certified
- 2025-04-23
Frequently asked questions
- What is Jefferson Park Pediatrics P C's NPI number?
- Jefferson Park Pediatrics P C's National Provider Identifier (NPI) is 1629263181, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Jefferson Park Pediatrics P C?
- Jefferson Park Pediatrics P C is classified in the NPPES registry as Pediatrics Physician (Allopathic & Osteopathic Physicians).
- Where is Jefferson Park Pediatrics P C located?
- Jefferson Park Pediatrics P C's practice location on file with NPPES is 3919 W Jefferson Blvd Ste 1, Fort Wayne, IN 46804-6811.
- What is Jefferson Park Pediatrics P C's phone number?
- The practice phone number listed in the NPPES registry for Jefferson Park Pediatrics P C is (260) 436-7722.
- Does Jefferson Park Pediatrics P C accept Medicare?
- Jefferson Park Pediatrics P C is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Jefferson Park Pediatrics P C?
- The authorized official listed on Jefferson Park Pediatrics P C's NPPES record is Giridhar Veerula, Owner. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Jefferson Park Pediatrics P C's NPI active?
- Yes — Jefferson Park Pediatrics P C's NPI (1629263181) is active in the NPPES registry as of the last update on 2025-04-23.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.