Individual provider Active NPI

Brett L. Skramstad, PA

  • Physician Assistant
  • Fort Wayne, IN
National Provider Identifier
1043657117
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
10001553A Issued in IN
Practice address
2200 Randallia Dr
Fort Wayne, IN 46805-4638
Phone
(260) 373-4000
Fax
(260) 482-4442
NPI assigned
May 30, 2013
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 10001553A IN Primary

Addresses

Primary practice location

2200 Randallia Dr
Fort Wayne, IN 46805-4638

Mailing address

608 Union Chapel Rd
Fort Wayne, IN 46845-9357
Phone (260) 482-4440

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130923000557 IN Practitioner - Physician Assistant 3870737307 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
95.38 of 100Reported as group
Quality
87.23
Promoting interoperability
100
Improvement activities
40
Cost
83.74

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Parkview Health System Inc CurrentSince Oct 4, 2023 Accepting new patients
Interventional Pain Consultants, LLC PastSince Feb 20, 2009 Accepting new patients

Locations

11109 Parkview Plaza Dr
Fort Wayne, IN 46845
Phone (260) 266-2020

2200 Randallia Dr
Fort Wayne, IN 46805
Phone (260) 373-4000

512 Professional Way
Kendallville, IN 46755
Phone (260) 347-8556

Interoperability endpoints

  • Direct secure messaging: bskramstad67774@direct.parkviewexchange.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1369872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1043657117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "608 UNION CHAPEL RD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468459357",
            "telephone_number": "260-482-4440",
            "fax_number": "260-482-4442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 RANDALLIA DR",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468054638",
            "telephone_number": "260-373-4000",
            "fax_number": "260-482-4442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKRAMSTAD",
        "first_name": "BRETT",
        "middle_name": "L.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-05-30",
        "last_updated": "2026-07-13",
        "certification_date": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IN",
            "license": "10001553A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

Verify at the official NPI Registry.