Individual provider Active NPI

Kirsten Elise Lengacher, PA-C

  • Medical Physician Assistant
  • Fort Wayne, IN
National Provider Identifier
1346002672
Registry record updated Jan 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
Practice address
2700 Lafayette St Ste 110
Fort Wayne, IN 46806-1100
Phone
(260) 266-0780
NPI assigned
Jan 23, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X Primary

Addresses

Primary practice location

2700 Lafayette St Ste 110
Fort Wayne, IN 46806-1100

Mailing address

2429 Dodge Ave
Fort Wayne, IN 46805-3831
Phone (517) 898-1392

Other names 1

  • Kirsten Elise Vanwieren Former name

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240503001504 IN Practitioner - Physician Assistant 0648610949 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Alliance Health Centers Inc. CurrentSince Apr 15, 2024 Accepting new patients

Locations

2700 Lafayette St
Ste 110
Fort Wayne, IN 46806
Phone (260) 660-0780

Interoperability endpoints

  • Direct secure messaging: klengacher654056@direct.parkviewexchange.com

Organizations & group practices 2

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": "1705968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705968000000",
    "number": "1346002672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2429 DODGE AVE",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468053831",
            "telephone_number": "517-898-1392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 LAFAYETTE ST STE 110",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468061100",
            "telephone_number": "260-266-0780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LENGACHER",
        "first_name": "KIRSTEN",
        "middle_name": "ELISE",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-23",
        "last_updated": "2024-01-23",
        "certification_date": "2024-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIRSTEN",
            "last_name": "VANWIEREN",
            "middle_name": "ELISE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fort Wayne, IN

Sources for this page

Verify at the official NPI Registry.