Active NPI
Fausto G. Devecchi, MD
- Clinical Cardiac Electrophysiology Physician
- Fort Wayne, IN
National Provider Identifier
1508078189
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Cardiac Electrophysiology Physician
- License
- 01066231A
- Practice address
- 7916 W Jefferson Blvd
Fort Wayne, IN 46804-4140 - Phone
- (260) 432-2297
- Fax
- (260) 434-6433
- NPI assigned
- May 4, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Cardiac Electrophysiology Physician | 207RC0001X | 01066231A | IN | Primary |
Addresses
Primary practice location
7916 W Jefferson Blvd
Fort Wayne, IN 46804-4140
Mailing address
6920 Pointe Inverness Way Ste 200
Medpartners, Attn: Barb Copeland
Fort Wayne, IN 46804-7934
Phone (260) 479-3514
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P00783755 | Other | IN | RAILROAD MEDICARE |
| 000000615407 | Other | IN | ANTHEM |
| 200943230 | Medicaid | IN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178236800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1482105600000",
"number": "1508078189",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6920 POINTE INVERNESS WAY STE 200",
"address_2": "MEDPARTNERS, ATTN: BARB COPELAND",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "468047934",
"telephone_number": "260-479-3514",
"fax_number": "260-479-3520"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7916 W JEFFERSON BLVD",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "468044140",
"telephone_number": "260-432-2297",
"fax_number": "260-434-6433"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEVECCHI",
"first_name": "FAUSTO",
"middle_name": "G.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-05-04",
"last_updated": "2016-12-19",
"status": "A"
},
"taxonomies": [
{
"code": "207RC0001X",
"taxonomy_group": "",
"desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
"state": "IN",
"license": "01066231A",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "P00783755",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM",
"identifier": "000000615407",
"state": "IN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200943230",
"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 Dec 19, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.