Jennifer Asuquo
Individual provider Active NPI Pediatrics Physician · Fort Wayne, IN
NPI 1689358087 · NPPES record last updated Jul 10, 2026
Key facts
- NPI
- 1689358087
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatrics Physician 208000000X
- License
- 01099496A (IN)
- Practice address
- 8028 Carnegie Blvd Ste 100
Fort Wayne, IN 46804-5789 - Phone
- (260) 373-9200
- Fax
- (260) 425-6914
- NPI assigned
- Jun 14, 2023
- Sex
- Female
- Sole proprietor
- No
Medicare Care Compare profile
- Specialty
- Pediatric Medicine
- Education
- Other, 2016
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
11109 Parkview Plaza Dr
Fort Wayne, IN 46845-1701
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 01099496A | IN | Yes |
| Student in an Organized Health Care Education/Training Program | 390200000X |
Addresses
Primary practice location
8028 Carnegie Blvd Ste 100
Fort Wayne, IN 46804-5789
Mailing address
11109 Parkview Plaza Dr # 117
Fort Wayne, IN 46845-1701
Other providers in Fort Wayne, IN
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- Astrum Wellness and Recovery LLC
- At Home and at Play Senior Support Services, Limited Liability Company
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All providers in Fort Wayne, IN · Pediatrics Physician in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 10, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.