Individual provider Active NPI

Austin Shepard

  • Physician Assistant
  • Fort Wayne, IN
National Provider Identifier
1194595090
Registry record updated May 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
7950 W Jefferson Blvd
Fort Wayne, IN 46804-4140
Phone
(260) 435-7001
NPI assigned
Jan 3, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 22, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

7950 W Jefferson Blvd
Fort Wayne, IN 46804-4140

Mailing address

7910 W Jefferson Blvd Ste 102
Fort Wayne, IN 46804-4159

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
I20240401000668 IN Practitioner - Physician Assistant 6406294198 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lutheran Medical Group LLCGroup PAC ID 4981751617, 251 clinicians

Practice addresses (Care Compare)

2516 E Dupont Rd
Fort Wayne, IN 46825-1608
Phone (260) 434-6076

7916 W Jefferson Blvd
Fort Wayne, IN 46804-4140
Phone (260) 432-2297

7938 W Jefferson Blvd
Fort Wayne, IN 46804-4140
Phone (260) 436-8583

7950 W Jefferson Blvd
Lutheran Hospital
Fort Wayne, IN 46804-4140
Phone (260) 435-7001

7952 W Jefferson Blvd
The Orthopedic Hospital
Fort Wayne, IN 46804-4140
Phone (260) 435-2999

7956 W Jefferson Blvd
Fort Wayne, IN 46804-4140
Phone (260) 435-2836

7970 W Jefferson Blvd
Fort Wayne, IN 46804-4140
Phone (260) 435-6105

7988 W Jefferson Blvd
Fort Wayne, IN 46804-4140
Phone (260) 969-7280

Hospital & facility affiliations

  • Lutheran Hospital of Indiana Hospital, Fort Wayne, IN, CCN 150017

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Lutheran Medical Group LLC CurrentSince Mar 25, 2024 Accepting new patients

Locations

7950 W Jefferson Blvd
Fort Wayne, IN 46804
Phone (260) 434-7088

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

7910 W Jefferson Blvd
Ste 102
Fort Wayne, IN 46804
Phone (260) 436-2424

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

Organizations & group practices 2

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": "1704240000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716336000000",
    "number": "1194595090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7910 W JEFFERSON BLVD STE 102",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468044159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7950 W JEFFERSON BLVD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468044140",
            "telephone_number": "260-435-7001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEPARD",
        "first_name": "AUSTIN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-01-03",
        "last_updated": "2024-05-22",
        "certification_date": "2024-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

Verify at the official NPI Registry.