Individual provider Active NPI

Michael C Overdahl, MD

  • Pulmonary Disease Physician
  • Fort Wayne, IN
National Provider Identifier
1316990112
Registry record updated Oct 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
01042341 Issued in IN
Practice address
11104 Parkview Circle Dr
Suite 410
Fort Wayne, IN 46845-1672
Phone
(260) 266-5260
Fax
(260) 266-5269
NPI assigned
May 19, 2006
Last updated
Oct 7, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X 01042341 IN Primary

Addresses

Primary practice location

11104 Parkview Circle Dr
Suite 410
Fort Wayne, IN 46845-1672

Mailing address

11109 Parkview Plaza Dr # 117
Fort Wayne, IN 46845-1701
Phone (260) 266-6013

Other identifiers 4

IdentifierTypeStateIssuer
000000576774OtherINANTHEM
000000670288OtherINANTHEM
P00685770OtherINRR MEDICARE
200015210MedicaidIN

Electronic endpoints 3

TypeEndpointUseAffiliation
Direct Messaging Address moverdahl8531@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
I20090130000015 IN Practitioner - Pulmonary DiseasePractitioner - Critical Care (Intensivists) 9436139631 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary DiseaseAlso: Critical Care (Intensivists)
Education
University of Minnesota Medical School, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Parkview Health System IncGroup PAC ID 2163336967, 1,350 clinicians

Practice addresses (Care Compare)

1101 Michigan Ave
Loganport, IN 46947-1528
Phone (574) 753-7541

11104 Parkview Circle Dr
Suite 430
Fort Wayne, IN 46845-0025
Phone (260) 425-6800

11104 Parkview Plaza Dr
410 PPG Pulmonary and Critical Care
Fort Wayne, IN 46845-1730
Phone (260) 266-7856

11108 Parkview Circle Dr
Fort Wayne, IN 46845-1730
Phone (260) 266-5700

11109 Parkview Plaza Dr
Fort Wayne, IN 46845-1701
Phone (260) 425-6030

11115 Parkview Plaza Dr
Fort Wayne, IN 46845-1701
Phone (260) 672-6443

2001 Stults Rd
Huntington, IN 46750-1291

2003 Stults Rd
Huntington, IN 46750-1291

207 N Townline Rd
Lagrange, IN 46761-1325

2200 Randallia Dr
Fort Wayne, IN 46805-4638
Phone (260) 425-6030

401 N Sawyer Rd
Kendallville, IN 46755-2568
Phone (260) 266-5700

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.53 of 100Reported as group
Quality
70
Promoting interoperability
100
Improvement activities
40
Cost
75.11

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01042341INMDPulmonary Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Parkview Health System Inc Current Accepting new patients
Parkview Health System, Inc. CurrentSince Aug 1, 2008 Accepting new patients
Indiana Medical Associates, LLC Past Accepting new patients

Locations

11104 Parkview Circle Dr
Ste 10
Fort Wayne, IN 46845
Phone (260) 266-7856

11104 Parkview Circle Dr
Ste 410
Fort Wayne, IN 46845
Phone (260) 266-7856

11109 Parkview Plaza Dr
#117
Fort Wayne, IN 46845
Phone (260) 266-6012

1818 Carew St
Ste 110
Fort Wayne, IN 46805
Phone (260) 969-7100

3702 New Vision Dr
Bldg B
Fort Wayne, IN 46845
Phone (260) 266-8210

7910 W Jefferson Blvd
Ste 120
Fort Wayne, IN 46804
Phone (260) 435-7612

240 S Jefferson St
Ste B
Huntington, IN 46750
Phone (219) 259-0000

512 Professional Way
Kendallville, IN 46755
Phone (260) 347-8556

Interoperability endpoints

  • Direct secure messaging: moverdahl8531@direct.parkviewexchange.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1147996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665100800000",
    "number": "1316990112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11109 PARKVIEW PLAZA DR # 117",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468451701",
            "telephone_number": "260-266-6013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11104 PARKVIEW CIRCLE DR",
            "address_2": "SUITE 410",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468451672",
            "telephone_number": "260-266-5260",
            "fax_number": "260-266-5269"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OVERDAHL",
        "first_name": "MICHAEL",
        "middle_name": "C",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-19",
        "last_updated": "2022-10-07",
        "certification_date": "2022-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "IN",
            "license": "01042341",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000576774",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000670288",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00685770",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200015210",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "moverdahl8531@Direct.Parkviewexchange.com",
            "affiliation": "N",
            "address_1": "11104 Parkview Circle Dr",
            "address_2": "suite 410",
            "city": "Fort Wayne",
            "state": "IN",
            "country_code": "US",
            "postal_code": "468451672",
            "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": "11104 Parkview Circle Dr",
            "address_2": "suite 410",
            "city": "Fort Wayne",
            "state": "IN",
            "country_code": "US",
            "postal_code": "468451672",
            "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": "11104 Parkview Circle Dr",
            "address_2": "suite 410",
            "city": "Fort Wayne",
            "state": "IN",
            "country_code": "US",
            "postal_code": "468451672",
            "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.