Active NPI
Mitchell B Stucky, M.D.
- Family Medicine Physician
- Fort Wayne, IN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 01028697A
- Practice address
- 3909 New Vision Dr
Fort Wayne, IN 46845-1725 - Phone
- (260) 469-6602
- Fax
- (260) 969-3065
- NPI assigned
- Aug 21, 2006
- Last updated
- Oct 20, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 01028697A | IN | Primary |
Addresses
Primary practice location
3909 New Vision Dr
Fort Wayne, IN 46845-1725
Mailing address
11109 Parkview Plaza Dr # 117
Fort Wayne, IN 46845-1701
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100055130 | Medicaid | IN | |
| 000000595590 | Other | IN | ANTHEM |
| P00698411 | Other | IN | MEDICARE RR |
Electronic endpoints 3
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | mstucky8318@Direct.Parkviewexchange.com | ||
| FHIR URL | https://epicprod-mobile.parkview.com/FHIR/api/FHIR/DSTU2/ | ||
| FHIR URL | https://epicprod-mobile.parkview.com/FHIR/api/FHIR/R4/ |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- Indiana University School of Medicine, 1978
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
3909 New Vision Dr
Fort Wayne, IN 46845-1725
817 Trail Ridge Rd
Albion, IN 46701-1534
Phone (260) 373-9590
Hospital & facility affiliations
- Parkview Health at Home LLC
- Adoration Home Health
- Parkview Regional Medical Center
- Parkview Dekalb Hospital
- Parkview Whitley Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 83.53 of 100
- Quality
- 70
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 75.11
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of skin lesions | 1-10 |
| Removal or shaving of skin growth | 1-10 |
| Skin biopsy | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01028697A | IN | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Parkview Health System Inc | Family Medicine | Current | Accepting new patients |
| Major Hospital | Past | Accepting new patients | |
| First Care Family Physicians, PC | Family Medicine | Past | Accepting new patients |
Locations
817 Trail Ridge Rd
Albion, IN 46701
Phone (260) 373-9590
11109 Parkview Plaza Dr
#117
Fort Wayne, IN 46845
Phone (260) 266-6012
1234 E DuPont Rd
Ste 3
Fort Wayne, IN 46825
Phone (260) 373-9965
3909 New Vision Dr
Fort Wayne, IN 46845
Phone (260) 373-8000
Interoperability endpoints
- mstucky8318@direct.parkviewexchange.com
Ownership & related parties
All facility ownership & control disclosures 1
Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.
| Facility | Type | Role | Since |
|---|---|---|---|
| Park Center Inc | Hospital | Corporate Officer W-2 Managing Employee |
Jan 1, 2026 Jan 1, 2026 |
Owned or controlled facilities with NPI records 1
Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.
-
- Psychiatric Hospital
- Fort Wayne, IN
- NPI 1457772402
Corporate Officer, W-2 Managing Employee
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Parkview Physicians Group
- Family Medicine Physician
- Fort Wayne, IN
- NPI 1932130952
-
- Family Medicine Physician
- Fort Wayne, IN
- NPI 1659372274
-
- General Acute Care Hospital
- Shelbyville, IN
- NPI 1174555692
Hospital & facility affiliations 7
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Amedisys Home Health of Marion
- Home Health Agency
- Marion, IN
- NPI 1497959142
-
dba Parkview Dekalb Hospital
- General Acute Care Hospital
- Auburn, IN
- NPI 1902897937
-
- Home Health Agency
- Fort Wayne, IN
- NPI 1861252918
-
dba Parkview Regional Medical Center
- General Acute Care Hospital
- Fort Wayne, IN
- NPI 1366407603
-
dba Parkview Whitley Hospital
- General Acute Care Hospital
- Columbia City, IN
- NPI 1205844495
-
dba Parkview Whitley Hospital
- Land Ambulance
- Columbia City, IN
- NPI 1497764450
Hospital
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": "1666224000000",
"number": "1700991338",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11109 PARKVIEW PLAZA DR # 117",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "468451701"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3909 NEW VISION DR",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "468451725",
"telephone_number": "260-469-6602",
"fax_number": "260-969-3065"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STUCKY",
"first_name": "MITCHELL",
"middle_name": "B",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-21",
"last_updated": "2022-10-20",
"certification_date": "2022-10-20",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "IN",
"license": "01028697A",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100055130",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM",
"identifier": "000000595590",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE RR",
"identifier": "P00698411",
"state": "IN"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "mstucky8318@Direct.Parkviewexchange.com",
"affiliation": "N",
"address_1": "3909 New Vision Dr",
"city": "Fort Wayne",
"state": "IN",
"country_code": "US",
"postal_code": "468451725",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://epicprod-mobile.parkview.com/FHIR/api/FHIR/DSTU2/",
"affiliation": "N",
"address_1": "3909 New Vision Dr",
"city": "Fort Wayne",
"state": "IN",
"country_code": "US",
"postal_code": "468451725",
"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": "3909 New Vision Dr",
"city": "Fort Wayne",
"state": "IN",
"country_code": "US",
"postal_code": "468451725",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Fort Wayne, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; 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.