Individual provider Active NPI

Edward Charles Sarkisian, M.D.

  • Dermatology Physician
  • Fort Wayne, IN
National Provider Identifier
1548368301
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
01046000A Issued in IN
Practice address
5750 Falls Dr
Fort Wayne, IN 46804-7147
Phone
(260) 436-8000
Fax
(260) 432-5587
NPI assigned
Sep 20, 2006
Last updated
Mar 7, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 01046000A IN Primary
Procedural Dermatology Physician 207NS0135X 01046000A IN

Addresses

Primary practice location

5750 Falls Dr
Fort Wayne, IN 46804-7147

Mailing address

5750 Falls Dr
Fort Wayne, IN 46804-7147
Phone (260) 436-8000

Other identifiers 6

IdentifierTypeStateIssuer
01046000BOtherINCSR LICENSE NUMBER
200132880MedicaidIN
7633OtherPHP
000000308068OtherBCBS
5878557OtherAETNA
P00074814OtherMEDICARE RAILROAD

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
I20040720000869 IN Practitioner - Dermatology 9830178672 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
University of Cincinnati College of Medicine, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fort Wayne Dermatology Consultants IncGroup PAC ID 0042299885, 14 clinicians

Practice addresses (Care Compare)

7881 Carnegie Blvd
Fort Wayne, IN 46804-5792
Phone (260) 436-8000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.59 of 100Reported as group
Quality
89.18
Promoting interoperability
99
Improvement activities
40
Cost
90.28

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions563
Removal or shaving of skin growth118
Skin biopsy143

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01046000AINMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Fort Wayne Dermatology Consultants Inc Dermatology CurrentSince Oct 1, 2003 Accepting new patients
Bluffton Physician Services LLC Past Accepting new patients
Caylor Nickel Clinic, PC Past Accepting new patients
Airway Oxygen, Inc. Past Accepting new patients

Locations

5750 Falls Dr
Fort Wayne, IN 46804
Phone (260) 204-5719

7881 Carnegie Blvd
Fort Wayne, IN 46804

Interoperability endpoints

  • Direct secure messaging: esarkisian@fwderm.emadirect.md

Organizations & group practices 4

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 1

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": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1548368301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5750 FALLS DR",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468047147",
            "telephone_number": "260-436-8000",
            "fax_number": "260-432-5587"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5750 FALLS DR",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468047147",
            "telephone_number": "260-436-8000",
            "fax_number": "260-432-5587"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SARKISIAN",
        "first_name": "EDWARD",
        "middle_name": "CHARLES",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "IN",
            "license": "01046000A",
            "primary": true
        },
        {
            "code": "207NS0135X",
            "taxonomy_group": "",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "IN",
            "license": "01046000A",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CSR LICENSE NUMBER",
            "identifier": "01046000B",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200132880",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHP",
            "identifier": "7633",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "000000308068",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5878557",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00074814",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

Verify at the official NPI Registry.