Individual provider Active NPI

Aydin T. Kizilisik, MD

  • Surgery Physician
  • Fort Wayne, IN
National Provider Identifier
1255415352
Registry record updated Jul 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
01062836A Issued in IN
Practice address
7910 W Jefferson Blvd
Suite 200
Fort Wayne, IN 46804-4159
Phone
(260) 435-6275
Fax
(260) 435-6279
NPI assigned
Oct 25, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Transplant Surgery Physician 204F00000X 01062836A IN
Surgery Physician 208600000X 01062836A IN Primary

Addresses

Primary practice location

7910 W Jefferson Blvd
Suite 200
Fort Wayne, IN 46804-4159

Mailing address

6920 Pointe Inverness Way Ste 200
Medpartners, Attn: Barb Copeland
Fort Wayne, IN 46804-7934
Phone (260) 479-3514

Other identifiers 1

IdentifierTypeStateIssuer
200861790MedicaidIN

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
I20070412000415 IN Practitioner - General SurgeryPractitioner - Family PracticePractitioner - Peripheral Vascular Disease 5092739342 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General SurgeryAlso: Peripheral Vascular Disease
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vohra Wound Physicians of the West PCGroup PAC ID 5890931331, 17 clinicians

Practice addresses (Care Compare)

1701 McDowell Rd
Evansville, IN 47712-5431
Phone (877) 866-7123

614 W 14TH St
Marion, IN 46953-2158
Phone (877) 866-7123

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue483
Removal of skin lesions13

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01062836AINMDTransplant Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Vohra Wound Physicians of the West, P.C. CurrentSince Dec 9, 2019 Accepting new patients

Locations

3601 SW 160th Ave
Ste 250
Miramar, FL 33027
Phone (305) 866-9951

9465 Counselors Row
Ste 200
Indianapolis, IN 46240
Phone (463) 220-4646

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.

NPI Registry JSON

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753401600000",
    "number": "1255415352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6920 POINTE INVERNESS WAY STE 200",
            "address_2": "MEDPARTNERS, ATTN: BARB COPELAND",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468047934",
            "telephone_number": "260-479-3514",
            "fax_number": "260-479-3520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7910 W JEFFERSON BLVD",
            "address_2": "SUITE 200",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468044159",
            "telephone_number": "260-435-6275",
            "fax_number": "260-435-6279"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIZILISIK",
        "first_name": "AYDIN",
        "middle_name": "T.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-25",
        "last_updated": "2025-07-25",
        "certification_date": "2025-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204F00000X",
            "taxonomy_group": "",
            "desc": "Transplant Surgery",
            "state": "IN",
            "license": "01062836A",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IN",
            "license": "01062836A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200861790",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

Verify at the official NPI Registry.