Active NPI
Garrett Bennett, M.D.
- Vascular & Interventional Radiology Physician
- Fort Wayne, IN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Vascular & Interventional Radiology Physician
- License
- 01082465A
- Practice address
- 11104 Parkview Circle Dr Suite 110
Fort Wayne, IN 46845 - Phone
- (260) 425-6780
- Fax
- (260) 425-6615
- NPI assigned
- Jun 4, 2012
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | 306317 | LA | |
| Student in an Organized Health Care Education/Training Program | 390200000X | LA | ||
| Vascular & Interventional Radiology Physician | 2085R0204X | 01082465A | IN | Primary |
Addresses
Primary practice location
11104 Parkview Circle Dr Suite 110
Fort Wayne, IN 46845
Mailing address
11109 Parkview Plaza Dr # 117
Fort Wayne, IN 46845-1701
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 300028176 | Medicaid | IN |
Electronic endpoints 3
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | gbennett218952@Direct.Parkviewexchange.com | ||
| FHIR URL | https://epicprod-mobile.parkview.com/FHIR/api/FHIR/DSTU2/ | ||
| FHIR URL | https://epicprod-mobile.parkview.com/FHIR/api/FHIR/R4/ |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Interventional Radiology
- Education
- Other, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
11104 Parkview Circle Dr
Fort Wayne, IN 46845-1672
Phone (206) 266-5400
Hospital & facility affiliations
- Parkview Regional Medical Center
- Parkview Whitley Hospital
- Parkview Wabash Hospital, Inc
- Cameron Health
- Community Hospitals and Wellness Centers
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Parkview Health System Inc | Current | Accepting new patients |
Locations
817 Trail Ridge Rd
Albion, IN 46701
Phone (260) 373-9590
11104 Parkview Circle Dr
Ste 110
Fort Wayne, IN 46845
Phone (260) 425-6780
11109 Parkview Plaza Dr
#117
Fort Wayne, IN 46845
Phone (260) 266-6012
3702 New Vision Dr
Bldg B
Fort Wayne, IN 46845
Phone (260) 266-8210
240 S Jefferson St
Ste B
Huntington, IN 46750
Phone (219) 259-0000
Interoperability endpoints
- gbennett218952@direct.parkviewexchange.com
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.
-
- Family Medicine Physician
- Fort Wayne, IN
- NPI 1932130952
Hospital & facility affiliations 6
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Critical Access Hospital
- Angola, IN
- NPI 1386683316
-
- General Acute Care Hospital
- Fort Wayne, IN
- NPI 1366407603
-
- Critical Access Hospital
- Wabash, IN
- NPI 1245259878
-
- General Acute Care Hospital
- Columbia City, IN
- NPI 1205844495
-
- General Acute Care Hospital
- Bryan, OH
- NPI 1962458521
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1338768000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1683244800000",
"number": "1174884431",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11109 PARKVIEW PLAZA DR # 117",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "468451701"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11104 PARKVIEW CIRCLE DR SUITE 110",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "46845",
"telephone_number": "260-425-6780",
"fax_number": "260-425-6615"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BENNETT",
"first_name": "GARRETT",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-06-04",
"last_updated": "2023-05-05",
"certification_date": "2023-05-05",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "LA",
"license": "306317",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "LA",
"license": null,
"primary": false
},
{
"code": "2085R0204X",
"taxonomy_group": "",
"desc": "Radiology, Vascular & Interventional Radiology",
"state": "IN",
"license": "01082465A",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "300028176",
"state": "IN"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "gbennett218952@Direct.Parkviewexchange.com",
"affiliation": "N",
"address_1": "11104 Parkview Circle Dr Suite 110",
"city": "Fort Wayne",
"state": "IN",
"country_code": "US",
"postal_code": "46845",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://epicprod-mobile.parkview.com/FHIR/api/FHIR/DSTU2/",
"affiliation": "N",
"address_1": "11104 Parkview Circle Dr Suite 110",
"city": "Fort Wayne",
"state": "IN",
"country_code": "US",
"postal_code": "46845",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://epicprod-mobile.parkview.com/FHIR/api/FHIR/R4/",
"affiliation": "N",
"address_1": "11104 Parkview Circle Dr Suite 110",
"city": "Fort Wayne",
"state": "IN",
"country_code": "US",
"postal_code": "46845",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Fort Wayne, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.