Individual provider Active NPI

Duane M Wampler, PA-C

  • Surgical Physician Assistant
  • Fort Wayne, IN
National Provider Identifier
1154312122
Registry record updated Jul 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
10000266A Issued in IN
Practice address
7881 Carnegie Blvd
Fort Wayne, IN 46804-5792
Phone
(260) 436-8000
Fax
(260) 436-0929
NPI assigned
Oct 31, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 10000266A IN Primary

Addresses

Primary practice location

7881 Carnegie Blvd
Fort Wayne, IN 46804-5792

Mailing address

1802 Day Rd
Mishawaka, IN 46545-4329
Phone (574) 204-7200

Other practice location 1

3505 N State Road 15 Ste C
Warsaw, IN 46582-5504
Phone (260) 436-8000

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
I20111104000209 IN Practitioner - Physician Assistant 8527231653 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fort Wayne Dermatology Consultants IncGroup PAC ID 0042299885, 14 clinicians

Practice addresses (Care Compare)

7881 Carnegie Blvd
Fort Wayne, IN 46804-5792
Phone (260) 436-8000

Hospital & facility affiliations

  • Kosciusko Community Hospital Hospital, Warsaw, IN, CCN 150133
  • Parkview Whitley Hospital Hospital, Columbia City, IN, CCN 150101

Merit-based Incentive Payment System (MIPS)

Final score
93.59 of 100Reported as group
Quality
89.18
Promoting interoperability
99
Improvement activities
40
Cost
90.28

National Provider Directory

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

Organizations & group practices 1

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 3

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": "1130716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752105600000",
    "number": "1154312122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1802 DAY RD",
            "city": "MISHAWAKA",
            "state": "IN",
            "postal_code": "465454329",
            "telephone_number": "574-204-7200",
            "fax_number": "574-252-0633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7881 CARNEGIE BLVD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468045792",
            "telephone_number": "260-436-8000",
            "fax_number": "260-436-0929"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3505 N State Road 15 Ste C",
            "address_purpose": "LOCATION",
            "city": "Warsaw",
            "state": "IN",
            "postal_code": "465825504",
            "country_code": "US",
            "telephone_number": "260-436-8000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WAMPLER",
        "first_name": "DUANE",
        "middle_name": "M",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-31",
        "last_updated": "2025-07-10",
        "certification_date": "2025-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "IN",
            "license": "10000266A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

Verify at the official NPI Registry.