JACQUELINE D COMBELLICK (MD) – General Practice Physician, NPI 1780694794
General Practice Physician
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Doctor Profile
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Profile Insights
NPPES metrics only — not quality of care.
1,268 EMERGENCY MEDICINE in IN
Provider Addresses for JACQUELINE D COMBELLICK (MD)
996 S State Road 135 Ste P
Greenwood, IN 461437366
Phone: (317) 893-3888
Type: Location
North Shadeland Avenue, Castleton, Vertland, Indianapolis, Indiana, 46250, United States
SUITE 130
INDIANAPOLIS, IN 462194959
Phone: (317) 963-0860
Type: Mailing
Indiana University North Hospital, 11700, North Meridian Street, Carmel, Hamilton County, Indiana, 46032, United States
CARMEL, IN 460324656
Phone: (317) 688-3139
Fax: (317) 688-2664
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: 2004-12-14
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20041214000859 | I | Emergency Medicine | IN | TBD |
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.
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 46143)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | IN | |
| Nurse Practitioner | IN | |
| Nurse Practitioner | IN | |
| Physician Assistant | IN | |
| Family Practice | IN | |
| - | IN | |
| Nurse Practitioner | IN | |
| Nurse Practitioner | IN | |
| - | IN | |
| Physician Assistant | TX |
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