Individual provider Active NPI

,Birute L Pumputis, MD

  • Family Medicine Physician
  • Fort Wayne, IN
National Provider Identifier
1326048455
Registry record updated Mar 23, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
01032732A Issued in IN
Practice address
3909 New Vision Dr
Fort Wayne, IN 46845-1725
Phone
(260) 469-6610
Fax
(260) 969-3065
NPI assigned
Jul 29, 2005
Last updated
Mar 23, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2017

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 01032732A IN Primary

Addresses

Primary practice location

3909 New Vision Dr
Fort Wayne, IN 46845-1725

Mailing address

3926 New Vision Dr
Fort Wayne, IN 46845-1712
Phone (260) 266-1401

Other identifiers 1

IdentifierTypeStateIssuer
200153780MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01032732AINMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Healthpartners Medical Group, LLC Past Accepting new patients
Summit Speech & Language Care Inc Past Accepting new patients
Gama PC Inc Past Accepting new patients
St Mary Medical Center Inc Past Accepting new patients

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1122595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490227200000",
    "number": "1326048455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3926 NEW VISION DR",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468451712",
            "telephone_number": "260-266-1401",
            "fax_number": "260-458-5734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3909 NEW VISION DR",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468451725",
            "telephone_number": "260-469-6610",
            "fax_number": "260-969-3065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUMPUTIS",
        "first_name": ",BIRUTE",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-29",
        "last_updated": "2017-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01032732A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200153780",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 Mar 23, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.