Individual provider Active NPI

David John Moran, MD

  • Family Medicine Physician
  • Fort Wayne, IN
National Provider Identifier
1679688295
Registry record updated May 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
01044168A Issued in IN
Practice address
10215 Auburn Park Dr
Fort Wayne, IN 46825-2387
Phone
(260) 234-5400
Fax
(317) 968-1475
NPI assigned
Aug 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 16, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 01044168A IN Primary

Addresses

Primary practice location

10215 Auburn Park Dr
Fort Wayne, IN 46825-2387

Mailing address

10215 Auburn Park Dr
Fort Wayne, IN 46825-2387
Phone (260) 234-5400

Other practice location 1

5104 N Clinton St
Fort Wayne, IN 46825-5720
Phone (260) 422-2481

Other identifiers 3

IdentifierTypeStateIssuer
P00698427OtherINMEDICARE RR
000000595587OtherINANTHEM
200150750MedicaidIN

Electronic endpoints 4

TypeEndpointUseAffiliation
FHIR URL https://epicprod-mobile.parkview.com/FHIR/api/FHIR/DSTU2/
FHIR URL https://epicprod-mobile.parkview.com/FHIR/api/FHIR/R4/
Direct Messaging Address dmoran@direct.iuhealth.org Direct
Direct Messaging Address dmoran2@iuhealth.org 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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090108000122 IN Practitioner - Family Practice 2163420910 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Indiana University School of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Iu Health Medical Group LLCGroup PAC ID 9638617913, 4,382 clinicians

Practice addresses (Care Compare)

1701 N Senate Ave
Indianapolis, IN 46202-5306
Phone (317) 962-2000

Hospital & facility affiliations

  • Indiana University Health Ball Memorial Hospital Hospital, Muncie, IN, CCN 150089
  • Parkview Regional Medical Center Hospital, Fort Wayne, IN, CCN 150021
  • Parkview Noble Hospital Hospital, Kendallville, IN, CCN 150146

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01044168AINMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Indiana University Health Fort Wayne Physicians, LLC Family Medicine CurrentSince Apr 20, 2025 Accepting new patients
Credo Health Group, LLC Family Medicine CurrentSince Mar 18, 2019 Accepting new patients
Iu Health Medical Group, LLC CurrentSince Oct 1, 2025 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients
First Care Family Physicians, PC Family Medicine Past Accepting new patients

Locations

10050 Auburn Park Dr
Fort Wayne, IN 46825
Phone (260) 432-6459

256 E Pettit Ave
Ste 100
Fort Wayne, IN 46806

10215 Auburn Park Dr
Fort Wayne, IN 46825
Phone (260) 490-2229

1701 Senate Blvd
Indianapolis, IN 46202
Phone (317) 612-2754

1701 N Senate Ave
Indianapolis, IN 46202
Phone (317) 929-8447

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 3

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": "1156118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747353600000",
    "number": "1679688295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10215 AUBURN PARK DR",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468252387",
            "telephone_number": "260-234-5400",
            "fax_number": "317-968-1475"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10215 AUBURN PARK DR",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468252387",
            "telephone_number": "260-234-5400",
            "fax_number": "317-968-1475"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5104 N Clinton St",
            "address_purpose": "LOCATION",
            "city": "Fort Wayne",
            "state": "IN",
            "postal_code": "468255720",
            "country_code": "US",
            "telephone_number": "260-422-2481",
            "fax_number": "260-969-3067",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MORAN",
        "first_name": "DAVID",
        "middle_name": "JOHN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-21",
        "last_updated": "2025-05-16",
        "certification_date": "2025-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01044168A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RR",
            "identifier": "P00698427",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000595587",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200150750",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicprod-mobile.parkview.com/FHIR/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "10050 Auburn Park Dr",
            "city": "Fort Wayne",
            "state": "IN",
            "country_code": "US",
            "postal_code": "468252389",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicprod-mobile.parkview.com/FHIR/api/FHIR/R4/",
            "affiliation": "N",
            "address_1": "10050 Auburn Park Dr",
            "city": "Fort Wayne",
            "state": "IN",
            "country_code": "US",
            "postal_code": "468252389",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dmoran@direct.iuhealth.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "10215 Auburn Park Dr",
            "city": "Fort Wayne",
            "state": "IN",
            "country_code": "US",
            "postal_code": "468252387",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dmoran2@iuhealth.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "10215 Auburn Park Dr",
            "city": "Fort Wayne",
            "state": "IN",
            "country_code": "US",
            "postal_code": "468252387",
            "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.