Nicholas Defauw, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

02005770A Issued in IN

Practice address

1111 Lighthouse LN
Goshen, IN 46526-3824

Phone

(260) 266-4007

Fax

(260) 266-7355

NPI assigned

Jul 1, 2009

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

Sports Medicine

Education

Michigan State University College of Osteopathic Medicine, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Parkview Health System IncGroup PAC ID 2163336967, 1,350 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Parkview Lagrange Hospital Hospital, Lagrange, IN, CCN 151323

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: nicholas.defauw@goshenhealthdirect.com

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.

• Parkview Health System Inc

  • Family Medicine Physician
  • Fort Wayne, IN
  • NPI 1932130952
  Medicare reassignment Care Compare group
• Goshen Health System Inc

  • Family Medicine Physician
  • Goshen, IN
  • NPI 1194772293
  NPD
• Goshen Health System Inc

  • Radiology Clinic/Center
  • Goshen, IN
  • NPI 1588190284
  NPD
• Goshen Hospital Association Inc

  • General Acute Care Hospital
  • Goshen, IN
  • NPI 1740268846
  NPD

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

• Community Hospital of Lagrange County Inc

  • Critical Access Hospital
  • Lagrange, IN
  • NPI 1679674956
  Care Compare affiliation

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

{
    "created_epoch": "1246406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777852800000",
    "number": "1578791398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11109 PARKVIEW PLAZA DR # 117",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468451701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 LIGHTHOUSE LN",
            "city": "GOSHEN",
            "state": "IN",
            "postal_code": "465263824",
            "telephone_number": "260-266-4007",
            "fax_number": "260-266-7355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEFAUW",
        "first_name": "NICHOLAS",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-07-01",
        "last_updated": "2026-05-04",
        "certification_date": "2026-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "02005770A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300029326",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nicholas.defauw@goshenhealthdirect.com",
            "affiliation": "N",
            "endpointDescription": "Effective 5/15/2023",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "1824 Dorchester Ct Ste A",
            "city": "Goshen",
            "state": "IN",
            "country_code": "US",
            "postal_code": "46526",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Mariovani P De Freitas, PHARM.D
• Morgan Elizabeth De Kleine, CNM, FNP-BC
• Christiaan Erik De Vries, M.D.
• Mark E Deal, DDS
• Deana Fugate DMD PC
• John Dejong, RPH
• Gabriela Del Real, BSW
• Kaitlyn E Delgado, FNP-BC
• Victoria Delgado
• Peter M Delneky, MD

• Family Medicine Physician in Goshen, IN
• Providers in Goshen, IN by specialty
• Family Medicine Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2026; 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.