Jan Magno De Guzman, MD

Primary specialty

Adult Medicine PhysicianTaxonomy code 207QA0505X

License

01083919A Issued in IN

Practice address

10215 Auburn Park Dr
Fort Wayne, IN 46825-2387

Phone

(260) 234-5400

Fax

(260) 234-5110

NPI assigned

Jun 18, 2017

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

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

Specialty

Family Practice

Education

Indiana University School of Medicine, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Iu Health Medical Group LLCGroup PAC ID 9638617913, 4,382 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Adoration Home Health Home health agency, Fort Wayne, IN, CCN 157583
• Heartland Home Health (Fort Wayne) Home health agency, Fort Wayne, IN, CCN 157205
• Indiana University Health Ball Memorial Hospital Hospital, Muncie, IN, CCN 150089
• Dupont Hospital LLC Hospital, Fort Wayne, IN, CCN 150150
• Parkview Regional Medical Center Hospital, Fort Wayne, IN, CCN 150021
• Indiana University Health Hospital, Indianapolis, IN, CCN 150056

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jdeguzman1@direct.iuhealth.org

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.

• Iu Health Medical Group, LLC

  • General Practice Physician
  • Indianapolis, IN
  • NPI 1326893777
  Medicare reassignment Care Compare group NPD
• Indiana University Health Ball Memorial Physicians, Inc.

  • Family Medicine Physician
  • Muncie, IN
  • NPI 1235455544
  Medicare reassignment NPD
• Indiana University Health Fort Wayne Physicians, LLC

  • Family Medicine Physician
  • Muncie, IN
  • NPI 1316550445
  NPD
• Indiana University Health Ball Memorial Physicians, Inc.

  • Hospitalist Physician
  • Muncie, IN
  • NPI 1598938037
  NPD (past)
• Major Hospital

  • General Acute Care Hospital
  • Shelbyville, IN
  • NPI 1174555692
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Amedisys SP-in, L.L.C.

  • Home Health Agency
  • Marion, IN
  • NPI 1497959142
  Care Compare affiliation
• Amedisys SP-in, LLC

  • Home Health Agency
  • Fort Wayne, IN
  • NPI 1437103199
  Care Compare affiliation
• Dupont Hospital LLC

  • General Acute Care Hospital
  • Fort Wayne, IN
  • NPI 1538110556
  Care Compare affiliation
• East Rockets HH, LLC

  • Home Health Agency
  • Fort Wayne, IN
  • NPI 1588364806
  Care Compare affiliation
• Indiana University Health Ball Memorial Hospital, Inc.

  • General Acute Care Hospital
  • Muncie, IN
  • NPI 1225195340
  Care Compare affiliation
• Indiana University Health Inc

  • General Acute Care Hospital
  • Indianapolis, IN
  • NPI 1144266024
  Care Compare affiliation
• Parkview Hospital, Inc.

  • General Acute Care Hospital
  • Fort Wayne, IN
  • NPI 1366407603
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1497744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639526400000",
    "number": "1477083848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 N SHADELAND AVE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462194959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10215 AUBURN PARK DR",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468252387",
            "telephone_number": "260-234-5400",
            "fax_number": "260-234-5110"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7411 Hope Dr",
            "address_purpose": "LOCATION",
            "city": "Fort Wayne",
            "state": "IN",
            "postal_code": "468155687",
            "country_code": "US",
            "telephone_number": "260-264-5600",
            "fax_number": "260-444-2082",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DE GUZMAN",
        "first_name": "JAN",
        "middle_name": "MAGNO",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-18",
        "last_updated": "2021-12-15",
        "certification_date": "2021-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "IN",
            "license": "01083919A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "11019468A",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jdeguzman1@direct.iuhealth.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "7411 Hope Dr",
            "city": "Fort Wayne",
            "state": "IN",
            "country_code": "US",
            "postal_code": "468155687",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Amy Dawson, MD
• Darika Dawson, RBT
• Kandi Denise Dawson, RD, CD, CDE
• Lesley Dawson, BSN, RN
• Sara Day, LPN
• Alexandra Maria De Lellis
• Luann Deafenbaugh, NP
• Dean Ullrich Acsw LCSW PC
• Joanne Dean
• Josie J Dean, NP

• Adult Medicine Physician in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Adult Medicine Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.