NPIMap

Individual provider Active NPI

Lauren May Koffman, DO

  • Neurology Physician
  • Fort Wayne, IN
National Provider Identifier
1346531282
Registry record updated Apr 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
OS021236 Issued in PA
Practice address
11104 Parkview Circle Dr Ste 110
Fort Wayne, IN 46845-1673
Phone
(260) 425-6780
NPI assigned
Apr 26, 2011
Last updated
Apr 14, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2022

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Neurocritical Care Physician 2084A2900X 036-143142 IL
Neurocritical Care Physician 2084A2900X 02006260A IN
Neurology Physician 2084N0400X H79360 MD
Neurology Physician 2084N0400X OS021236 PA Primary

Addresses

Primary practice location

11104 Parkview Circle Dr Ste 110
Fort Wayne, IN 46845-1673

Mailing address

1725 W Harrison St
Suite 1106
Chicago, IL 60612
Phone (312) 942-4500

Other practice location 1

1725 W Harrison St Ste 1106
Chicago, IL 60612-3845
Phone (312) 942-4500

Other practice location 2

2005 Technology Pkwy Ste 400
Mechanicsburg, PA 17050-9413
Phone (717) 791-2520

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN, PA2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20210422001654 IN Practitioner - Neuropsychiatry 2062726276 Reassigns benefits to 1 organization
I20211001000292 PA Practitioner - Neurology 2062726276 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Neuropsychiatry
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Parkview Health System IncGroup PAC ID 2163336967, 1,350 clinicians
Temple Faculty Practice Plan IncGroup PAC ID 0345588711, 1,325 clinicians

Practice addresses (Care Compare)

11104 Parkview Circle Dr
Fort Wayne, IN 46845-1672
Phone (206) 266-5400

3401 N Broad St
Philadelphia, PA 19140-5103
Phone (215) 707-5030

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.21 of 100Reported as group
Quality
49.71
Promoting interoperability
100
Improvement activities
40
Cost
74.23

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 Osteopathy

State licenses

LicenseStateTypeSpecialty
036-143142ILMDNeurocritical Care Physician
02006260AINMDNeurocritical Care Physician
H79360MDMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Temple Faculty Practice Plan, Inc Neurology CurrentSince Aug 15, 2021 Accepting new patients
Pinnacle Health Medical Services CurrentSince Apr 1, 2022 Accepting new patients
Temple Faculty Practice Plan Inc CurrentSince Aug 15, 2021 Accepting new patients
Temple Faculty Practice Plan Inc Current Accepting new patients
Parkview Health System Inc CurrentSince Mar 28, 2021 Accepting new patients
Pinnacle Health Medical Services Current Accepting new patients
Pinnacle Health Medical Services CurrentSince Apr 1, 2022 Accepting new patients
Temple University Hospital, Inc Past Accepting new patients

Locations

817 Trail Ridge Rd
Albion, IN 46701
Phone (260) 373-9590

11104 Parkview Circle Dr
Ste 110
Fort Wayne, IN 46845
Phone (260) 425-6780

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

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

515 Pennsylvania Ave
Ft Washington, PA 19034
Phone (215) 641-0700

2501 N 3rd St
Fl 2
Harrisburg, PA 17110
Phone (717) 782-2100

2005 Technology Pkwy
Ste 400
Mechanicsburg, PA 17050

2450 W Hunting Park Ave
Philadelphia, PA 19129
Phone (215) 707-2433

3401 N Broad St
Philadelphia, PA 19140
Phone (215) 707-3807

Interoperability endpoints

  • Direct secure messaging: lkoffman135519@direct.rush.rush-health.com

Organizations & group practices 8

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 10

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": "1303776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649894400000",
    "number": "1346531282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1725 W HARRISON ST",
            "address_2": "SUITE 1106",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60612",
            "telephone_number": "312-942-4500",
            "fax_number": "312-942-6755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11104 PARKVIEW CIRCLE DR STE 110",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468451673",
            "telephone_number": "260-425-6780"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1725 W Harrison St Ste 1106",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606123845",
            "country_code": "US",
            "telephone_number": "312-942-4500",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2005 Technology Pkwy Ste 400",
            "address_purpose": "LOCATION",
            "city": "Mechanicsburg",
            "state": "PA",
            "postal_code": "170509413",
            "country_code": "US",
            "telephone_number": "717-791-2520",
            "fax_number": "717-703-0061",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOFFMAN",
        "first_name": "LAUREN",
        "middle_name": "MAY",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-04-26",
        "last_updated": "2022-04-14",
        "certification_date": "2022-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084A2900X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurocritical Care",
            "state": "IL",
            "license": "036-143142",
            "primary": false
        },
        {
            "code": "2084A2900X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurocritical Care",
            "state": "IN",
            "license": "02006260A",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "MD",
            "license": "H79360",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "PA",
            "license": "OS021236",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

Verify at the official NPI Registry.