Individual provider Active NPI

Kiran Wasiq, MD

  • Internal Medicine Physician
  • Fort Wayne, IN
National Provider Identifier
1467143321
Registry record updated Jun 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
01099068A Issued in IN
Practice address
11109 Parkview Plaza Dr
Fort Wayne, IN 46845-1701
Phone
(260) 672-6620
Fax
(260) 672-6639
NPI assigned
May 19, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 01099068A IN Primary

Addresses

Primary practice location

11109 Parkview Plaza Dr
Fort Wayne, IN 46845-1701

Mailing address

465 W Putnam Ave
Porterville, CA 93257-3320
Phone (559) 788-6156

Other practice location 1

465 W. Putnam Avenue
Porterville, CA 93257
Phone (559) 788-6156

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260219002318 IN Practitioner - Internal Medicine 6608356498 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2016
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

11109 Parkview Plaza Dr
Suite 117
Fort Wayne, IN 46845-1701

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01099068AINMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Parkview Health System, Inc. Internal Medicine CurrentSince Feb 10, 2026 Accepting new patients

Locations

11109 Parkview Plaza Dr
Fort Wayne, IN 46845
Phone (260) 266-2020

512 Professional Way
Kendallville, IN 46755
Phone (260) 347-8556

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, 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": "1684454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780272000000",
    "number": "1467143321",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "465 W PUTNAM AVE",
            "city": "PORTERVILLE",
            "state": "CA",
            "postal_code": "932573320",
            "telephone_number": "559-788-6156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11109 PARKVIEW PLAZA DR",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468451701",
            "telephone_number": "260-672-6620",
            "fax_number": "260-672-6639"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "465 W. Putnam Avenue",
            "address_purpose": "LOCATION",
            "city": "Porterville",
            "state": "CA",
            "postal_code": "93257",
            "country_code": "US",
            "telephone_number": "559-788-6156",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WASIQ",
        "first_name": "KIRAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-19",
        "last_updated": "2026-06-01",
        "certification_date": "2026-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IN",
            "license": "01099068A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

Verify at the official NPI Registry.