Individual provider Active NPI

Caleb Parker Suciu, DC

  • Chiropractor
  • Fort Wayne, IN
National Provider Identifier
1609209691
Registry record updated Jul 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
08002725A Issued in IN
Practice address
12812 Coldwater Rd
Ste 101
Fort Wayne, IN 46845
Phone
(260) 445-8389
Fax
(888) 607-1633
NPI assigned
Aug 14, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 08002725A IN Primary

Addresses

Primary practice location

12812 Coldwater Rd
Ste 101
Fort Wayne, IN 46845

Mailing address

12812 Coldwater Rd
Ste 101
Fort Wayne, IN 46845
Phone (260) 445-8389

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190307001867 IN Practitioner - Chiropractic 7214276302 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
National College of Chiropractic, 2013
Medicare assignment
May accept Medicare assignment
Group practices
Crossroads Wellness Center, LLCGroup PAC ID 6406195593, 5 clinicians

Practice addresses (Care Compare)

12812 Coldwater Rd
Suite 101
Fort Wayne, IN 46845-9516
Phone (260) 445-8389

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Crossroads Wellness Center, LLC Chiropractor CurrentSince Jan 29, 2019 Accepting new patients
Burns Physical Therapy and Wellness Company CurrentSince Feb 19, 2023 Accepting new patients
Edgewood Chiropractic Center PC Chiropractor PastSince Jul 1, 2005 Accepting new patients

Locations

12812 Coldwater Rd
#101
Fort Wayne, IN 46845
Phone (260) 445-8389

9206 Lima Rd
Fort Wayne, IN 46818
Phone (260) 445-8389

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1376438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688688000000",
    "number": "1609209691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12812 COLDWATER RD",
            "address_2": "STE 101",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "46845",
            "telephone_number": "260-445-8389",
            "fax_number": "888-607-1633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12812 COLDWATER RD",
            "address_2": "STE 101",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "46845",
            "telephone_number": "260-445-8389",
            "fax_number": "888-607-1633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUCIU",
        "first_name": "CALEB",
        "middle_name": "PARKER",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-08-14",
        "last_updated": "2023-07-07",
        "certification_date": "2023-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IN",
            "license": "08002725A",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Jul 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.