Individual provider Active NPI

Sam Rhoades, PA-C

  • Physician Assistant
  • Fort Wayne, IN
National Provider Identifier
1619691748
Registry record updated Sep 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
10003816A Issued in IN
Practice address
11104 Parkview Circle Dr Ste 330
Fort Wayne, IN 46845-1674
Phone
(260) 494-3484
Fax
(260) 969-0188
NPI assigned
Oct 3, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 10003816A IN Primary

Addresses

Primary practice location

11104 Parkview Circle Dr Ste 330
Fort Wayne, IN 46845-1674

Mailing address

120 W 22ND St
Oak Brook, IL 60523-1557
Phone (630) 573-5000

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address credentialing@nephdocs.com Direct

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221119000170 IN Practitioner - Physician Assistant 0840668067 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Nephrology Associates of Northern Indiana PCGroup PAC ID 8921033440, 64 clinicians

Practice addresses (Care Compare)

11104 Parkview Circle Dr
Suite 330
Fort Wayne, IN 46845-1674
Phone (260) 494-3484

569 Tyler St
Gary, IN 46402-1829
Phone (260) 885-3300

7836 W Jefferson Blvd
101 Nephrology Associates of Northern India
Fort Wayne, IN 46804-4178
Phone (260) 494-3484

Hospital & facility affiliations

  • Parkview Regional Medical Center Hospital, Fort Wayne, IN, CCN 150021
  • Parkview Dekalb Hospital Hospital, Auburn, IN, CCN 150045
  • Adams Memorial Hospital Hospital, Decatur, IN, CCN 151330
  • Parkview Huntington Hospital Hospital, Huntington, IN, CCN 150091
  • Parkview Whitley Hospital Hospital, Columbia City, IN, CCN 150101

Merit-based Incentive Payment System (MIPS)

Final score
83.85 of 100Reported as group
Promoting interoperability
81
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Fort Wayne Orthopaedics, LLC CurrentSince Oct 27, 2022 Accepting new patients
Racc Medical Associates LLC CurrentSince Aug 29, 2024 Accepting new patients
Fort Wayne Orthopaedics LLC Physician Assistant CurrentSince Oct 27, 2022 Accepting new patients
Racc Medical Associates LLC CurrentSince Aug 29, 2024 Accepting new patients

Locations

1314 E 7th St
Ste 201
Auburn, IN 46706
Phone (260) 927-0400

820 Smaltz Way
Ste B
Auburn, IN 46706
Phone (260) 432-1800

1721 Magnavox Way
#A
Fort Wayne, IN 46804
Phone (260) 250-0001

10106 DuPont Circle Dr E
Ste 150
Fort Wayne, IN 46825

10319 Dawsons Creek Blvd
Ste F
Fort Wayne, IN 46825

7601 W Jefferson Blvd
Fort Wayne, IN 46804
Phone 26043686864254

519 Professional Way
Kendallville, IN 46755
Phone (260) 347-3770

330 N Wabash Ave
Ste 410
Marion, IN 46952
Phone (765) 651-4265

1025 Manchester Ave
Ste A
Wabash, IN 46992

2124 N Biomet Dr
Warsaw, IN 46582
Phone (574) 267-2663

Interoperability endpoints

  • Direct secure messaging: srhoades81616@direct.acumenmd.com

Organizations & group practices 5

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.

Hospital & facility affiliations 6

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": "1664755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756944000000",
    "number": "1619691748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 W 22ND ST",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605231557",
            "telephone_number": "630-573-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11104 PARKVIEW CIRCLE DR STE 330",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468451674",
            "telephone_number": "260-494-3484",
            "fax_number": "260-969-0188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RHOADES",
        "first_name": "SAM",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-10-03",
        "last_updated": "2025-09-04",
        "certification_date": "2025-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IN",
            "license": "10003816A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "credentialing@nephdocs.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "120 W 22nd St",
            "city": "Oak Brook",
            "state": "IL",
            "country_code": "US",
            "postal_code": "605231557",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

Verify at the official NPI Registry.