Provider Demographics
NPI:1699459719
Name:LOEWENSTEIN, JAKE TIMOTHY (PA-C)
Entity type:Individual
Prefix:
First Name:JAKE
Middle Name:TIMOTHY
Last Name:LOEWENSTEIN
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8185 SPENCER CT
Mailing Address - Street 2:
Mailing Address - City:PLAINFIELD
Mailing Address - State:IN
Mailing Address - Zip Code:46168-5672
Mailing Address - Country:US
Mailing Address - Phone:208-615-6958
Mailing Address - Fax:
Practice Address - Street 1:6820 PARKDALE PL STE 212
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46254-6600
Practice Address - Country:US
Practice Address - Phone:317-216-2700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-09
Last Update Date:2025-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical