Individual provider Active NPI

Patrick M. Veerkamp, M.D.

  • Dermatology Physician
  • Fort Wayne, IN
National Provider Identifier
1174059109
Registry record updated Nov 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
01085080A Issued in IN
Practice address
7881 Carnegie Blvd
Fort Wayne, IN 46804-5792
Phone
(260) 436-8000
Fax
(260) 434-0929
NPI assigned
May 11, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 01085080A IN Primary

Addresses

Primary practice location

7881 Carnegie Blvd
Fort Wayne, IN 46804-5792

Mailing address

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

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN, OH2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20210518000712 IN Practitioner - Dermatology 8224307483 Reassigns benefits to 1 organization
I20211019000782 OH Practitioner - Dermatology 8224307483 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Indiana University School of Medicine, 2017
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)

208 Columbus St
Hicksville, OH 43526-1250
Phone (260) 436-8000

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

Hospital & facility affiliations

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

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision65
Removal of skin lesions987
Removal or shaving of skin growth1-10
Skin biopsy363

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Fort Wayne Dermatology Consultants Inc Dermatology CurrentSince Jul 1, 2021 Accepting new patients

Locations

454 E DuPont Rd
Fort Wayne, IN 46825
Phone (239) 888-4910

7881 Carnegie Blvd
Fort Wayne, IN 46804

208 Columbus St
Hicksville, OH 43526
Phone (419) 542-6692

1035 W Wayne St
Paulding, OH 45879
Phone (419) 399-4080

Interoperability endpoints

  • Direct secure messaging: pveerkamp@fwderm.emadirect.md

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 1

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": "1494460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635897600000",
    "number": "1174059109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7881 CARNEGIE BLVD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468045792",
            "telephone_number": "260-436-8000",
            "fax_number": "260-434-0929"
        },
        {
            "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": "260-434-0929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VEERKAMP",
        "first_name": "PATRICK",
        "middle_name": "M.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-05-11",
        "last_updated": "2021-11-03",
        "certification_date": "2021-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "IN",
            "license": "01085080A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

Verify at the official NPI Registry.