Active NPI
David S. Mohan, MD
- Family Medicine Physician
- Fort Wayne, IN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 01073536A
- Practice address
- 3534 Brooklyn Ave
Fort Wayne, IN 46809-1361 - Phone
- (260) 478-5130
- Fax
- (260) 478-5133
- NPI assigned
- Jul 16, 2010
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 01073536A | IN | |
| Family Medicine Physician | 207Q00000X | 01073536A | IN | Primary |
Addresses
Primary practice location
3534 Brooklyn Ave
Fort Wayne, IN 46809-1361
Mailing address
6920 Pointe Inverness Way Ste 200
Fort Wayne, IN 46804-7934
Phone (260) 479-3516
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 201214460 | Medicaid | IN |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | david.mohan@lutheranhealthnetwork.cernerdirect.com |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- Wayne State University School of Medicine, 2001
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
235 Hauenstein Rd
Huntington, IN 46750-8803
Phone (260) 504-4110
2516 E Dupont Rd
Fort Wayne, IN 46825-1608
Phone (260) 434-6076
3534 Brooklyn Ave
Fort Wayne, IN 46809-1361
Phone (260) 432-2297
Hospital & facility affiliations
- Caretenders
- Adoration Home Health
- Lutheran Hospital of Indiana
- St Joseph Health System, LLC
- Dupont Hospital LLC
- Parkview Regional Medical Center
Merit-based Incentive Payment System (MIPS)
- Final score
- 90.99 of 100
- Quality
- 77.41
- Promoting interoperability
- 100
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01073536A | IN | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lutheran Medical Group LLC | Current | Accepting new patients | |
| Lutheran Medical Group LLC | Internal Medicine | Current | Accepting new patients |
Locations
2516 E DuPont Rd
Fort Wayne, IN 46825
Phone (260) 434-6076
3534 Brooklyn Ave
Fort Wayne, IN 46809
Phone (219) 478-5180
6920 Pointe Inverness Way
Ste 200
Fort Wayne, IN 46804
Phone (260) 479-3514
7916 W Jefferson Blvd
Fort Wayne, IN 46804
Phone (260) 432-2298
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 and National Provider Directory roles.
-
- Cardiovascular Disease Physician
- Fort Wayne, IN
- NPI 1164662805
Internal Medicine
-
- Durable Medical Equipment & Medical Supplies
- Fort Wayne, IN
- NPI 1710275664
Hospital & facility affiliations 7
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Home Health Agency
- Marion, IN
- NPI 1497959142
-
- Home Health Agency
- Fort Wayne, IN
- NPI 1437103199
-
- General Acute Care Hospital
- Fort Wayne, IN
- NPI 1538110556
-
- General Acute Care Hospital
- Fort Wayne, IN
- NPI 1306897335
-
- General Acute Care Hospital
- Fort Wayne, IN
- NPI 1366407603
-
- Home Health Agency
- Fort Wayne, IN
- NPI 1073776399
-
- General Acute Care Hospital
- Fort Wayne, IN
- NPI 1023060472
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1279238400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1602547200000",
"number": "1578876785",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6920 POINTE INVERNESS WAY STE 200",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "468047934",
"telephone_number": "260-479-3516",
"fax_number": "260-479-3520"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3534 BROOKLYN AVE",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "468091361",
"telephone_number": "260-478-5130",
"fax_number": "260-478-5133"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOHAN",
"first_name": "DAVID",
"middle_name": "S.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-07-16",
"last_updated": "2020-10-13",
"certification_date": "2020-10-13",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "IN",
"license": "01073536A",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "IN",
"license": "01073536A",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "201214460",
"state": "IN"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "david.mohan@lutheranhealthnetwork.cernerdirect.com",
"affiliation": "N",
"endpointDescription": "AMR direct address",
"address_1": "3534 Brooklyn Ave",
"city": "Fort Wayne",
"state": "IN",
"country_code": "US",
"postal_code": "468091361",
"country_name": "United States",
"address_type": "DOM"
}
],
"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 Oct 13, 2020; 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.