NPIMap

Individual provider Active NPI

Bryan Christopher Umberg, PA-C

  • Physician Assistant
  • Fort Wayne, IN
National Provider Identifier
1346493012
Registry record updated Jul 31, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
10001305A Issued in IN
Practice address
2200 Randallia Dr
Fort Wayne, IN 46805-4638
Phone
(260) 373-4000
Fax
(260) 482-4442
NPI assigned
Oct 28, 2008
Last updated
Jul 31, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 002839 OH
Physician Assistant 363A00000X 10001305A IN Primary

Addresses

Primary practice location

2200 Randallia Dr
Fort Wayne, IN 46805-4638

Mailing address

3640 New Vision Drive
Suite a
Fort Wayne, IN 46845-1717
Phone (260) 482-4440

Other identifiers 1

IdentifierTypeStateIssuer
000000745961OtherINANTHEM

Medicare participation

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

Care Compare profile

Medicare Care Compare

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

Merit-based Incentive Payment System (MIPS)

Final score
95.38 of 100Reported as group
Quality
87.23
Promoting interoperability
100
Improvement activities
40
Cost
83.74

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
10001305AINMDPhysician Assistant
002839OHMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Parkview Wabash Hospital, Inc. Past Accepting new patients
University of Cincinnati Physicians, Inc. Physician Assistant Past Accepting new patients
Vanguard Medical Past Accepting new patients
University of Cincinnati Physicians Company, LLC Physician Assistant Past Accepting new patients
Parkview Health System Inc Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: bumberg12349@direct.parkviewexchange.com

Organizations & group practices 5

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": "1225152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1375228800000",
    "number": "1346493012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3640 NEW VISION DRIVE",
            "address_2": "SUITE A",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468451717",
            "telephone_number": "260-482-4440",
            "fax_number": "260-482-4442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 RANDALLIA DR",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468054638",
            "telephone_number": "260-373-4000",
            "fax_number": "260-482-4442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UMBERG",
        "first_name": "BRYAN",
        "middle_name": "CHRISTOPHER",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-10-28",
        "last_updated": "2013-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "002839",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IN",
            "license": "10001305A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000745961",
            "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 Jul 31, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.