Individual provider Active NPI

Todd Robert Page, MD

  • Family Medicine Physician
  • Fort Wayne, IN
National Provider Identifier
1184622367
Registry record updated Jun 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
01047310 Issued in IN
Practice address
5501 US Highway 30 W
Fort Wayne, IN 46818-8998
Phone
(260) 270-6181
Fax
(260) 469-1022
NPI assigned
Jul 12, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 01047310 IN Primary

Addresses

Primary practice location

5501 US Highway 30 W
Fort Wayne, IN 46818-8998

Mailing address

5501 US Highway 30 W
Fort Wayne, IN 46818-8998
Phone (260) 270-6181

Other identifiers 4

IdentifierTypeStateIssuer
5988752OtherINAETNA
15D0962889OtherINCLIA
200218780AMedicaidIN
01047310OtherINSTATE LICENSE

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
I20100309000339 IN Practitioner - Family Practice 4587561626 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
97.04 of 100Reported as group
Quality
79.76
Promoting interoperability
94
Improvement activities
40
Cost
85.08

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01047310INMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Neighborhood Health Clinics, Inc Family Medicine CurrentSince Jul 1, 2024 Accepting new patients
Neighborhood Health Clinics, Inc CurrentSince Jul 1, 2024 Accepting new patients
Auburn Family Medicine Family Medicine PastSince Aug 1, 1999 Accepting new patients

Locations

750 Broadway
Ste 350
Fort Wayne, IN 46802
Phone (260) 423-2675

1717 S Calhoun St
Fort Wayne, IN 46802
Phone (260) 458-2641

750 Broadway
Ste 250
Fort Wayne, IN 46802
Phone (260) 423-2675

1721 S Calhoun St
Fort Wayne, IN 46802
Phone (260) 458-2571

Interoperability endpoints

  • Direct secure messaging: todd.page@nhci.eclinicaldirectplus.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1121126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718150400000",
    "number": "1184622367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5501 US HIGHWAY 30 W",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468188998",
            "telephone_number": "260-270-6181",
            "fax_number": "260-469-1022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5501 US HIGHWAY 30 W",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468188998",
            "telephone_number": "260-270-6181",
            "fax_number": "260-469-1022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAGE",
        "first_name": "TODD",
        "middle_name": "ROBERT",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-12",
        "last_updated": "2024-06-12",
        "certification_date": "2024-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01047310",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5988752",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "15D0962889",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200218780A",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "01047310",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

Verify at the official NPI Registry.