Individual provider Active NPI

Renee Elizabeth Buskirk, PHD

  • Clinical Neuropsychologist
  • Fort Wayne, IN
National Provider Identifier
1619275807
Registry record updated Aug 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
20041648A Issued in IN
Practice address
11143 Parkview Plaza Dr Ste 207
Fort Wayne, IN 46845-1728
Phone
(260) 373-8000
Fax
(260) 266-5379
NPI assigned
Mar 11, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X 20041648A IN Primary

Addresses

Primary practice location

11143 Parkview Plaza Dr Ste 207
Fort Wayne, IN 46845-1728

Mailing address

3702 New Vision Dr BLDG B
Fort Wayne, IN 46845-1703

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110404000739 IN Practitioner - Clinical Psychologist 3577747260 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Parkview Health System IncGroup PAC ID 2163336967, 1,350 clinicians

Practice addresses (Care Compare)

11143 Parkview Plaza Dr
Suite 207
Fort Wayne, IN 46845-1728
Phone (260) 266-5370

Merit-based Incentive Payment System (MIPS)

Final score
83.53 of 100Reported as group
Quality
70
Promoting interoperability
100
Improvement activities
40
Cost
75.11

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20041648AINMDClinical Neuropsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Parkview Health System Inc CurrentSince Aug 1, 2019 Accepting new patients
Aims, LLC CurrentSince Sep 17, 2017 Accepting new patients

Locations

817 Trail Ridge Rd
Albion, IN 46701
Phone (260) 373-9590

417 S Whitlock St
Bremen, IN 46506
Phone (574) 546-0330

11104 Parkview Circle Dr
Ste 110
Fort Wayne, IN 46845
Phone (260) 425-6780

11143 Parkview Plaza Dr
Ste 207
Fort Wayne, IN 46845
Phone (260) 266-5370

3702 New Vision Dr
Bldg B
Fort Wayne, IN 46845
Phone (260) 266-8210

240 S Jefferson St
Ste B
Huntington, IN 46750
Phone (219) 259-0000

512 Professional Way
Kendallville, IN 46755
Phone (260) 347-8556

1625 E Jefferson Blvd
Mishawaka, IN 46545
Phone (219) 257-2295

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.

NPI Registry JSON

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

{
    "created_epoch": "1299801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566172800000",
    "number": "1619275807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3702 NEW VISION DR BLDG B",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468451703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11143 PARKVIEW PLAZA DR STE 207",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468451728",
            "telephone_number": "260-373-8000",
            "fax_number": "260-266-5379"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUSKIRK",
        "first_name": "RENEE",
        "middle_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-11",
        "last_updated": "2019-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "IN",
            "license": "20041648A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

Verify at the official NPI Registry.