JASON TREVOR QUEEN (PA-C) – Student in an Organized Health Care Education/Training Program, NPI 1184518854

JASON TREVOR QUEEN (PA-C) is a healthcare provider. based in Carmel, Indiana. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PA-C. They hold a License No. 10004870A (IN). The NPI Number for JASON TREVOR QUEEN (PA-C) is 1184518854

Main info

Male
Sole Proprietor
1 Year Of Experience
Accepts Medicare Assignment
Name
JASON TREVOR QUEEN (PA-C)
NPI
1184518854
Phone
(618) 960-6625
Address
3848 CONSTITUTION DR
Enumeration Date
5 June 2025
Last Update Date
28 November 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8884843258
Graduation Year
2025 (1 year ago)
PAC ID
2365950847
Group Practice PAC ID
9638617913
Professional Enrollment ID
I20250805002906
Address ID
IN479058764LA5165XLNXX300

Contacts

Secure Messaging
jqueen@direct.iuhealth.org
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience31
Completeness95
Years active:1State licenses:1Other names

2,499 PHYSICIAN ASSISTANT in IN

Provider Addresses for JASON TREVOR QUEEN (PA-C)

  • 3848 CONSTITUTION DR

    CARMEL, IN 460329350

    Phone: (618) 960-6625

    Type: Mailing

  • 5165 MCCARTY LN

    LAFAYETTE, IN 479058764

    Phone: (765) 448-8000

    Type: Location

  • 1300 S Jackson St

    Frankfort, IN 460413313

    Phone: (765) 656-3000

    Type: Location

  • 720 S 6th St

    Monticello, IN 479608182

    Phone: (574) 582-7111

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2025-08-05

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20250805002906IPhysician AssistantINTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 46032)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 9638617913View full group profile
NameSpecialtyState
Pediatric MedicineNC
U R O L O G YIN
Diagnostic Radiology, Interventional RadiologyNY
Nurse PractitionerIN
P A T H O L O G YIN
O T O L A R Y N G O L O G YIN
E N D O C R I N O L O G YIN
Family Practice, Sports MedicineIN
Gastroenterology, Internal MedicineIN
Orthopedic SurgeryMO

Reviews

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Frequently asked questions

Is JASON TREVOR QUEEN (PA-C) listed with a National Provider Identifier?
Yes — JASON TREVOR QUEEN (PA-C) has NPI 1184518854 on file in the registry.
Is JASON TREVOR QUEEN (PA-C) still an active registrant?
JASON TREVOR QUEEN (PA-C) carries an active NPI according to the public dataset.
What area of care is associated with JASON TREVOR QUEEN (PA-C)?
JASON TREVOR QUEEN (PA-C)'s record emphasizes Student in an Organized Health Care Education/Training Program. Clinical services aligned with this taxonomy classification.
What practice footprint exists for JASON TREVOR QUEEN (PA-C)?
Travel planning: use Carmel, Indiana as the reference point for JASON TREVOR QUEEN (PA-C), then confirm.
What does 4 location(s) imply?
4 practice locations appear in the available data.

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