Daniel Abreu, MD
Individual provider Active NPI Family Medicine Physician · Fort Wayne, IN
NPI 1093409591 · NPPES record last updated Jun 7, 2023
Key facts
- NPI
- 1093409591
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 11022951A (IN)
- Practice address
- 750 Broadway Ste 350
Fort Wayne, IN 46802-1412 - Phone
- (260) 423-2675
- Fax
- (260) 423-6621
- NPI assigned
- Jun 7, 2023
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- Indiana University School of Medicine, 2023
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
6619 Brotherhood Way
Fort Wayne, IN 46825-4226
750 Broadway
Suite 250
Fort Wayne, IN 46802-1411
750 Broadway
Suite 350
Fort Wayne, IN 46802-1412
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230620001259 | IN | Order and Referring Only - Family Practice |
0547628885 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11022951A | IN | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fort Wayne Medical Education Program | Family Medicine | Current |
Accepting new patients |
Locations
750 Broadway
Ste 250
Fort Wayne, IN 46802
Phone (260) 423-2675
750 Broadway
Ste 350
Fort Wayne, IN 46802
Phone (260) 423-2675
Interoperability endpoints
- daniel.abreu@nhci.eclinicaldirectplus.com
- daniel.abreu.1@17223.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 11022951A | IN | Yes |
Addresses
Primary practice location
750 Broadway Ste 350
Fort Wayne, IN 46802-1412
Mailing address
750 Broadway Ste 350
Fort Wayne, IN 46802-1412
Phone (260) 423-2675
NPI Registry JSON
{
"created_epoch": "1686096000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1686096000000",
"number": "1093409591",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "750 BROADWAY STE 350",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "468021412",
"telephone_number": "260-423-2675",
"fax_number": "260-423-6621"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "750 BROADWAY STE 350",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "468021412",
"telephone_number": "260-423-2675",
"fax_number": "260-423-6621"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ABREU",
"first_name": "DANIEL",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-06-07",
"last_updated": "2023-06-07",
"certification_date": "2023-06-07",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "IN",
"license": "11022951A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 7, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.