Nicholas Lee Nussbaum, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

01063067A Issued in IN

Practice address

1819 Carew St
Fort Wayne, IN 46805-4705

Phone

(260) 373-7770

Fax

(260) 373-7775

NPI assigned

Mar 28, 2007

Sex

Male

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

Indiana University School of Medicine, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Parkview Health System IncGroup PAC ID 2163336967, 1,350 clinicians

Adams County Memorial HospitalGroup PAC ID 0941198253, 85 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

83.61 of 100Reported as group

Quality

76.47

Promoting interoperability

100

Improvement activities

40

Cost

68.89

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: nnussbaum10686@direct.parkviewexchange.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.

• Adams County Memorial Hospital

  • Critical Access Hospital
  • Decatur, IN
  • NPI 1689696148
  Medicare reassignment Care Compare group NPD
• Parkview Health System Inc

  • Family Medicine Physician
  • Fort Wayne, IN
  • NPI 1932130952
  Medicare reassignment Care Compare group
• Adams County Memorial Hospital

  • Skilled Nursing Facility
  • Liberty, IN
  • NPI 1619176641
  NPD
• Lima Memorial Joint Operating Company

  • General Acute Care Hospital
  • Lima, OH
  • NPI 1336144732
  NPD (past)

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

{
    "created_epoch": "1175040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775174400000",
    "number": "1720107824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 TOWER DR",
            "city": "MONROE",
            "state": "IN",
            "postal_code": "467729362",
            "telephone_number": "260-692-6163",
            "fax_number": "260-728-3949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1819 CAREW ST",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468054705",
            "telephone_number": "260-373-7770",
            "fax_number": "260-373-7775"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "205 Tower Dr",
            "address_purpose": "LOCATION",
            "city": "Monroe",
            "state": "IN",
            "postal_code": "467729362",
            "country_code": "US",
            "telephone_number": "260-692-6163",
            "fax_number": "260-728-3949",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NUSSBAUM",
        "first_name": "NICHOLAS",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-28",
        "last_updated": "2026-04-03",
        "certification_date": "2026-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01063067A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200970670",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tiffani Nunn
• Nurse Johnson Transportation LLC
• Nurtured Home Care LLC
• Amirummul B Nusairee, MD
• Abaigale Nussbaum, RN
• Kloie Nutt, DO
• Nuvena Vein Center, LLC
• Chuck G Nwakanma
• Joyce I. Nwakanma, NP
• Hnin Nway, NP

• 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 Apr 3, 2026; 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.