Individual provider Active NPI

Brian David Reichenbach, M.D.

  • Family Medicine Physician
  • Warsaw, IN
National Provider Identifier
1255396529
Registry record updated Oct 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
01060938A Issued in IN
Practice address
2235 Dubois Dr
Warsaw, IN 46580-3212
Phone
(574) 267-8189
Fax
(574) 267-7554
NPI assigned
Apr 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2020

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 01060938A IN Primary

Addresses

Primary practice location

2235 Dubois Dr
Warsaw, IN 46580-3212

Mailing address

6920 Pointe Inverness Way Ste 200
Fort Wayne, IN 46804-7934
Phone (260) 479-3513

Other identifiers 1

IdentifierTypeStateIssuer
200808450MedicaidIN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address brian.reichenbach@lutheranhealthnetwork.cernerdirect.com

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
I20060405000382 IN Practitioner - Family Practice 4284642059 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Iowa, RJ & L Carver College of Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Kosciusko Medical Group LLCGroup PAC ID 5496809956, 41 clinicians

Practice addresses (Care Compare)

1205 Provident Dr a
Warsaw, IN 46580-3265
Phone (574) 269-8383

1275 Provident Dr
Warsaw, IN 46580-3265
Phone (574) 269-4026

2235 Dubois Dr
Warsaw, IN 46580-3212
Phone (574) 267-8189

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.99 of 100Reported as apm
Quality
77.41
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions14
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01060938AINMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kosciusko Medical Group LLC Family Medicine CurrentSince Nov 1, 2009 Accepting new patients

Locations

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

1904 Lake Ave
Plymouth, IN 46563
Phone (574) 214-7504

2235 Dubois Dr
Warsaw, IN 46580
Phone (260) 423-2567

1205 Provident Dr
#A
Warsaw, IN 46580
Phone (574) 269-8383

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 6

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": "1145404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601942400000",
    "number": "1255396529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6920 POINTE INVERNESS WAY STE 200",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468047934",
            "telephone_number": "260-479-3513",
            "fax_number": "260-479-3520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2235 DUBOIS DR",
            "city": "WARSAW",
            "state": "IN",
            "postal_code": "465803212",
            "telephone_number": "574-267-8189",
            "fax_number": "574-267-7554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REICHENBACH",
        "first_name": "BRIAN",
        "middle_name": "DAVID",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-19",
        "last_updated": "2020-10-06",
        "certification_date": "2020-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01060938A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200808450",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "brian.reichenbach@lutheranhealthnetwork.cernerdirect.com",
            "affiliation": "N",
            "endpointDescription": "AMR direct address",
            "address_1": "2235 DuBois Dr",
            "city": "Warsaw",
            "state": "IN",
            "country_code": "US",
            "postal_code": "465803212",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Warsaw, IN

Sources for this page

Verify at the official NPI Registry.