Lisa Michelle Holtsclaw, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

02001568A Issued in IN

Practice address

436 E Washington Blvd
Fort Wayne, IN 46802-3210

Phone

(260) 209-7111

Fax

(260) 222-2835

NPI assigned

Jan 19, 2006

Sex

Female

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

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

Family Practice

Education

At Still University of Health Sciences, College of Osteo Med, Kirksville, 1993

Medicare assignment

May accept Medicare assignment

Group practices

Osh-in Physicians Group PCGroup PAC ID 6800100512, 62 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Parkview Regional Medical Center Hospital, Fort Wayne, IN, CCN 150021

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lisa.holtsclaw@oakstreethealth.gwaydirect.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.

• Osh-in Physicians Group, PC

  • Primary Care Clinic/Center
  • Indianapolis, IN
  • NPI 1073995338

  Family Medicine

  Medicare reassignment Care Compare group NPD
• Holtsclaw Medical Centre, LLC

  • Family Medicine Physician
  • Fort Wayne, IN
  • NPI 1235146812
  NPD (past) Authorized official
• Lima Memorial Joint Operating Company

  • General Acute Care Hospital
  • Lima, OH
  • NPI 1336144732
  NPD (past)
• Oak Street Health Physicians Group, PC

  • Primary Care Clinic/Center
  • Chicago, IL
  • NPI 1083051643
  NPD (past)

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

• Parkview Hospital, Inc.

  • General Acute Care Hospital
  • Fort Wayne, IN
  • NPI 1366407603
  Care Compare affiliation

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

{
    "created_epoch": "1137628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592784000000",
    "number": "1619957164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 W MONROE ST STE 1200",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606032420",
            "telephone_number": "312-733-9730",
            "fax_number": "773-866-8014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "436 E WASHINGTON BLVD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468023210",
            "telephone_number": "260-209-7111",
            "fax_number": "260-222-2835"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLTSCLAW",
        "first_name": "LISA",
        "middle_name": "MICHELLE",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-19",
        "last_updated": "2020-06-22",
        "certification_date": "2020-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "02001568A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100373060",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ryan K Holmes, D.D.S.
• Anatasia Nicole Holscher, RBT
• Rebecca Anne Holsclaw, (TEMP) LSW
• Ashley N Holt, DPT
• Holtsclaw Medical Centre, LLC
• Janette L Holub, MD, MPH
• Holy Family Center, Inc
• Amy Marie Holzer, DC
• Home Care Services, Inc
• Home Gencare Inc.

• Family Medicine Physician in Fort Wayne, IN
• Providers in Fort Wayne, 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 Jun 22, 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.

Verify at the official NPI Registry.