Active NPI
Michael S. Mohrman, M.D.
- Family Medicine Physician
- Fort Wayne, IN
National Provider Identifier
1770574063
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 01027124A
- Practice address
- 1717 S Calhoun St
Fort Wayne, IN 46802 - Phone
- (260) 478-5140
- Fax
- (260) 478-5145
- NPI assigned
- Nov 4, 2005
- 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 | 01027124A | IN | Primary |
Addresses
Primary practice location
1717 S Calhoun St
Fort Wayne, IN 46802
Mailing address
1717 S Calhoun St
Fort Wayne, IN 46802-5257
Phone (260) 458-2641
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000000091878 | Other | BLUE CROSS BLUE SHIELD | |
| 100318070 | Medicaid | IN | |
| 080121950 | Other | IN | RAILROAD MEDICARE |
| 1610 | Other | PHYSICIANS HEALTH PLAN | |
| 000000000829 | Other | MPLAN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Brooklyn Medical Associates, PC | Family Medicine | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Family Medicine Physician
- Fort Wayne, IN
- NPI 1851512198
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1131062400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1530748800000",
"number": "1770574063",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1717 S CALHOUN ST",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "468025257",
"telephone_number": "260-458-2641"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1717 S CALHOUN ST",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "46802",
"telephone_number": "260-478-5140",
"fax_number": "260-478-5145"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOHRMAN",
"first_name": "MICHAEL",
"middle_name": "S.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-11-04",
"last_updated": "2018-07-05",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "IN",
"license": "01027124A",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "000000091878",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100318070",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "080121950",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHYSICIANS HEALTH PLAN",
"identifier": "1610",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MPLAN",
"identifier": "000000000829",
"state": null
}
],
"endpoints": [],
"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 Jul 5, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.