Individual provider Active NPI

Deanna Rae Ritter, NP

  • Primary Care Nurse Practitioner
  • Fort Wayne, IN
National Provider Identifier
1376207290
Registry record updated Oct 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
71011763A Issued in IN
Practice address
6326 Constitution Dr
Fort Wayne, IN 46804-1518
Phone
(260) 515-3275
NPI assigned
Oct 27, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 27, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X 71011763A IN Primary

Addresses

Primary practice location

6326 Constitution Dr
Fort Wayne, IN 46804-1518

Mailing address

2523 W Miami TRL
Marion, IN 46952-9670
Phone (765) 618-5041

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
I20211203000435 IN Practitioner - Nurse Practitioner 3274923347 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rounding ProvidersGroup PAC ID 5496947764, 15 clinicians

Practice addresses (Care Compare)

6326 Constitution Dr
Fort Wayne, IN 46804-1518
Phone (260) 515-3275

Merit-based Incentive Payment System (MIPS)

Final score
22.99 of 100Reported as individual
Quality
0
Promoting interoperability
0
Improvement activities
0
Cost
76.65

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
71011763AINMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Rounding Providers CurrentSince Oct 15, 2021 Accepting new patients

Locations

6326 Constitution Dr
Fort Wayne, IN 46804
Phone (260) 515-3275

Organizations & group practices 1

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": "1635292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635292800000",
    "number": "1376207290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2523 W MIAMI TRL",
            "city": "MARION",
            "state": "IN",
            "postal_code": "469529670",
            "telephone_number": "765-618-5041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6326 CONSTITUTION DR",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468041518",
            "telephone_number": "260-515-3275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RITTER",
        "first_name": "DEANNA",
        "middle_name": "RAE",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-10-27",
        "last_updated": "2021-10-27",
        "certification_date": "2021-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "IN",
            "license": "71011763A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

Verify at the official NPI Registry.