Individual provider Active NPI

Ronald J Pancner, MD

  • Psychiatry Physician
  • Fort Wayne, IN
National Provider Identifier
1316980576
Registry record updated Oct 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
01019854 Issued in IN
Practice address
2805 Fairfield Ave
Fort Wayne, IN 46807-1218
Phone
(260) 456-4880
Fax
(260) 456-3559
NPI assigned
Jun 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 01019854 IN Primary

Addresses

Primary practice location

2805 Fairfield Ave
Fort Wayne, IN 46807-1218

Mailing address

2805 Fairfield Ave
Fort Wayne, IN 46807-1218
Phone (260) 456-4880

Other practice location 1

1720 Beacon St
Fort Wayne, IN 46805-4749
Phone (260) 373-8000

Other practice location 2

909 E State Blvd
Fort Wayne, IN 46805-3404
Phone (260) 481-2700

Other identifiers 1

IdentifierTypeStateIssuer
100463070MedicaidIN

Electronic endpoints 3

TypeEndpointUseAffiliation
Direct Messaging Address rpancner8142@Direct.Parkviewexchange.com
FHIR URL https://epicprod-mobile.parkview.com/FHIR/api/FHIR/DSTU2/
FHIR URL https://epicprod-mobile.parkview.com/FHIR/api/FHIR/R4/

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
I20110520000119 IN Practitioner - Psychiatry 0547291031 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Northwestern University Feinberg Medical School, 1961
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2805 Fairfield Ave
Fort Wayne, IN 46807-1218
Phone (260) 456-4880

Merit-based Incentive Payment System (MIPS)

Final score
91.37 of 100Reported as group
Quality
80.38
Promoting interoperability
100
Improvement activities
40
Cost
74.18

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Pancner Psychiatric Associates, PC CurrentSince Jul 1, 1990 Accepting new patients

Locations

2805 Fairfield Ave
Fort Wayne, IN 46807
Phone (219) 456-4880

1720 Beacon St
Fort Wayne, IN 46805
Phone (260) 373-7500

Interoperability endpoints

  • Direct secure messaging: rpancner8142@direct.parkviewexchange.com

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": "1150243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666224000000",
    "number": "1316980576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2805 FAIRFIELD AVE",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468071218",
            "telephone_number": "260-456-4880",
            "fax_number": "260-456-3559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2805 FAIRFIELD AVE",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468071218",
            "telephone_number": "260-456-4880",
            "fax_number": "260-456-3559"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1720 Beacon St",
            "address_purpose": "LOCATION",
            "city": "Fort Wayne",
            "state": "IN",
            "postal_code": "468054749",
            "country_code": "US",
            "telephone_number": "260-373-8000",
            "fax_number": "260-373-8034",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "909 E State Blvd",
            "address_purpose": "LOCATION",
            "city": "Fort Wayne",
            "state": "IN",
            "postal_code": "468053404",
            "country_code": "US",
            "telephone_number": "260-481-2700",
            "fax_number": "260-481-2838",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PANCNER",
        "first_name": "RONALD",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-14",
        "last_updated": "2022-10-20",
        "certification_date": "2022-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IN",
            "license": "01019854",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100463070",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rpancner8142@Direct.Parkviewexchange.com",
            "affiliation": "N",
            "address_1": "1720 Beacon St",
            "city": "Fort Wayne",
            "state": "IN",
            "country_code": "US",
            "postal_code": "468054749",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicprod-mobile.parkview.com/FHIR/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "1720 Beacon St",
            "city": "Fort Wayne",
            "state": "IN",
            "country_code": "US",
            "postal_code": "468054749",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicprod-mobile.parkview.com/FHIR/api/FHIR/R4/",
            "affiliation": "N",
            "address_1": "1720 Beacon St",
            "city": "Fort Wayne",
            "state": "IN",
            "country_code": "US",
            "postal_code": "468054749",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

Verify at the official NPI Registry.