Individual provider Active NPI

Nicholai Ian Kiehl, MD

  • Urology Physician
  • Fort Wayne, IN
National Provider Identifier
1124269055
Registry record updated Oct 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
01073785A Issued in IN
Practice address
11141 Parkview Plaza Dr
Suite 320
Fort Wayne, IN 46845-1713
Phone
(260) 482-8681
Fax
(260) 266-9240
NPI assigned
Mar 24, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 35125593 OH
Urology Physician 208800000X 01073785A IN Primary

Addresses

Primary practice location

11141 Parkview Plaza Dr
Suite 320
Fort Wayne, IN 46845-1713

Mailing address

PO Box 7527
Dublin, OH 43017-0727

Other identifiers 3

IdentifierTypeStateIssuer
201228420MedicaidIN
0119494MedicaidOH
H411160OtherOHMEDICARE

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140902001216 IN Practitioner - Urology 4789802810 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
University of Cincinnati College of Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Adams County Memorial HospitalGroup PAC ID 0941198253, 85 clinicians

Practice addresses (Care Compare)

1100 Mercer Ave
Decatur, IN 46733-2303
Phone (260) 724-2145

Hospital & facility affiliations

  • Adams Memorial Hospital Hospital, Decatur, IN, CCN 151330
  • Van Wert County Hospital Hospital, Van Wert, OH, CCN 360071
  • Parkview Regional Medical Center Hospital, Fort Wayne, IN, CCN 150021
  • Community Hospitals and Wellness Centers Hospital, Bryan, OH, CCN 360121
  • Mercy Health St Ritas Medical Center Hospital, Lima, OH, CCN 360066

Merit-based Incentive Payment System (MIPS)

Final score
83.61 of 100Reported as group
Quality
76.47
Promoting interoperability
100
Improvement activities
40
Cost
68.89

Merit-based Incentive Payment System (MIPS)

Final score
90.99 of 100Reported as apm
Quality
77.41
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
80.04 of 100Reported as group
Quality
58.67
Promoting interoperability
98
Improvement activities
40
Cost
76.46

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
35125593OHMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lutheran Medical Group LLC CurrentSince May 14, 2024 Accepting new patients
Adams County Memorial Hospital CurrentSince Oct 1, 2024 Accepting new patients
Adams County Memorial Hospital CurrentSince Oct 1, 2024 Accepting new patients
Lutheran Medical Group LLC CurrentSince May 14, 2024 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

1100 Mercer Ave
Decatur, IN 46733

7910 W Jefferson Blvd
Ste 112
Fort Wayne, IN 46804
Phone (260) 969-7121

6920 Pointe Inverness Way
Ste 200
Fort Wayne, IN 46804
Phone (260) 479-3514

11141 Parkview Plaza Dr
Ste 200
Fort Wayne, IN 46845
Phone (260) 425-6030

2516 E DuPont Rd
Fort Wayne, IN 46825
Phone (260) 434-6076

1250 S Washington St
Van Wert, OH 45891
Phone (419) 232-2077

Organizations & group practices 5

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

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1237852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727827200000",
    "number": "1124269055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7527",
            "city": "DUBLIN",
            "state": "OH",
            "postal_code": "430170727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11141 PARKVIEW PLAZA DR",
            "address_2": "SUITE 320",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468451713",
            "telephone_number": "260-482-8681",
            "fax_number": "260-266-9240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIEHL",
        "first_name": "NICHOLAI",
        "middle_name": "IAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-03-24",
        "last_updated": "2024-10-02",
        "certification_date": "2024-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "OH",
            "license": "35125593",
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "IN",
            "license": "01073785A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201228420",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0119494",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "H411160",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

Verify at the official NPI Registry.