Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Jackie Suzanne Tank, PA

Individual provider Physician Assistant · NPI 1043854409

Jackie Suzanne Tank, PA is a Physician Assistant in Indianapolis, Indiana. Qualified in 2019, 7 years ago. Practices with Franciscan Physician Network, a 1,171-clinician group, works from 3 locations and accepts Medicare assignment. Licensed in Indiana.

Years since qualifying
7
Licensed in
IN
In the registry since
2019
Specialties on file
2
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

5255 E Stop 11 RD Ste 450
Indianapolis, IN 46237-6342
Phone: (317) 865-4800
Fax: (317) 865-4806
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 200 High Service Ave, North Providence, RI 02904-5113 — (401) 456-3000
  • 825 Chalkstone Ave, Providence, RI 02908-4728 — (401) 456-2000

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 10002853A (IN)
Physician Assistant Taxonomy 363A00000X

Record details

NPI number1043854409
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorNo
NPI enumeratedOctober 29, 2019
Last updated in NPPESMay 5, 2026
Certification dateMay 5, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Group practice Franciscan Physician Network — 1171 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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