NPIMap

Organization Active NPI

Fort Wayne Vascular Care LLC

Doing business as Nephrology Associates of Northern Indiana PC

  • Ambulatory Surgical Clinic/Center
  • Fort Wayne, IN
National Provider Identifier
1225684368
Registry record updated Feb 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
FORT WAYNE VASCULAR CARE LLC
Doing business as
Nephrology Associates of Northern Indiana PC
Practice address
1833 Magnavox Way # 100
Fort Wayne, IN 46804-1539
Phone
(260) 918-0997
Fax
(260) 436-7665
NPI assigned
Aug 14, 2019
Last updated
Feb 4, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2026

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

Authorized official

Name
Manish TannaNPI 1821096470
Title
MD
Phone
(630) 573-5000

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X Primary

Addresses

Primary practice location

1833 Magnavox Way # 100
Fort Wayne, IN 46804-1539

Mailing address

120 W 22ND St
Suite 200
Oak Brook, IL 60523-1563
Phone (630) 573-5000

Other names 1

  • Nephrology Associates of Northern Indiana PC Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20211208002288 IN Part B Supplier - Ambulatory Surgical Center 1557751443 Receives reassigned benefits from 5 practitioners
Practice locations: Fort Wayne, IN

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
Fort Wayne Vascular Care LLC Dba Nephrology Associates of Northern Indiana PCCCN 15C0001216
Medicare certification status
ActiveFrom the Provider of Services file

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
15D2164630Fort Wayne Vascular Care, LLC1833 Magnavox Way #100, Ft Wayne, IN 46804Certificate of waiverApr 9, 2027

National Provider Directory

National Provider Directory

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

  • Bridges Dialysis LLC

    dba Fort Wayne West Dialysis

    • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
    • Fort Wayne, IN
    • NPI 1366745630

    Member Of

    NPD member

Locations

1833 Magnavox Way
#100
Fort Wayne, IN 46804
Phone (260) 918-0997

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1565740800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1770163200000",
    "number": "1225684368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 W 22ND ST",
            "address_2": "SUITE 200",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605231563",
            "telephone_number": "630-573-5000",
            "fax_number": "630-368-0280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1833 MAGNAVOX WAY # 100",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468041539",
            "telephone_number": "260-918-0997",
            "fax_number": "260-436-7665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORT WAYNE VASCULAR CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-08-14",
        "last_updated": "2026-02-04",
        "certification_date": "2026-02-04",
        "status": "A",
        "authorized_official_last_name": "TANNA",
        "authorized_official_first_name": "MANISH",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "630-573-5000"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Nephrology Associates of Northern Indiana PC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Nephrology Associates of Northern Indiana PC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Feb 4, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.

Verify at the official NPI Registry.