Individual provider Active NPI

Benjamin Riebesel

  • Certified Registered Nurse Anesthetist
  • Fort Wayne, IN
National Provider Identifier
1801338769
Registry record updated Mar 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
28232032A Issued in IN
Practice address
5734 Coventry LN
Fort Wayne, IN 46804-7141
Phone
(260) 435-7973
NPI assigned
Nov 9, 2016
Last updated
Mar 11, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 28232032A IN Primary
Registered Nurse 163W00000X 28232032A IN

Addresses

Primary practice location

5734 Coventry LN
Fort Wayne, IN 46804-7141

Mailing address

12063 Lower Huntington Rd
Roanoke, IN 46783-9667
Phone (251) 599-6756

Other practice location 1

1373 E State Road 62
Madison, IN 47250-7328
Phone (812) 801-0609

Other identifiers 3

IdentifierTypeStateIssuer
412840169OtherINMEDICARE
7100910520MedicaidKY
300019421MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN, MI, OH3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20170131000598 IN Practitioner - Certified Registered Nurse Anesthetist (Crna) 1658653472 Reassigns benefits to 10 organizations
I20230301000756 MI Practitioner - Certified Registered Nurse Anesthetist (Crna) 1658653472 Reassigns benefits to 2 organizations
I20250623002198 OH Practitioner - Certified Registered Nurse Anesthetist (Crna) 1658653472 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2016
Medicare assignment
May accept Medicare assignment
Group practices
Clinical Colleagues IncGroup PAC ID 8729011333, 170 clinicians
Iceland Anesthesia Management LLCGroup PAC ID 7618372996, 75 clinicians
Australia Anesthesia Management LLCGroup PAC ID 9436671864, 58 clinicians
Cep America - Anesthesia PCGroup PAC ID 3678897915, 849 clinicians

Practice addresses (Care Compare)

1250 S Washington St
Van Wert County Hospital
Van Wert, OH 45891-2599
Phone (419) 238-8659

1260 E State Rd
Suite 205
Columbia City, IN 46725-9492
Phone (260) 248-9301

1421 N 7TH St
Terre Haute, IN 47807-1005
Phone (812) 232-7192

200 High Park Ave
Goshen, IN 46526-4810
Phone (574) 364-1000

274 E Chicago St
Coldwater, MI 49036-2041
Phone (517) 279-5400

401 N Sawyer Rd
Kendallville, IN 46755-2568
Phone (260) 347-8140

5215 Holy Cross Pkwy
Mishawaka, IN 46545-1469
Phone (574) 335-2443

701 S Health Pkwy
Three Rivers Health Hospital
Three Rivers, MI 49093-8352
Phone (269) 278-1145

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
28232032AINMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Saint Joseph Regional Medical Center-South Bend Campus, Inc Current Accepting new patients
Cep America - Anesthesia PC CurrentSince Oct 31, 2025 Accepting new patients
Norton - Kings Daughters Health Inc Nurse Anesthetist, Certified Registered CurrentSince Jul 19, 2023 Accepting new patients
Community Health Center of Branch County CurrentSince Dec 1, 2022 Accepting new patients
Community Health Center of Branch County Current Accepting new patients
Regio T Penna MD, PC Current Accepting new patients
Cep America - Anesthesia PC CurrentSince Oct 31, 2025 Accepting new patients
Community Health Center of Branch County Current Accepting new patients
Cameron Memorial Community Hospital, Inc. CurrentSince Oct 25, 2024 Accepting new patients
Norton - Kings Daughters Health Inc CurrentSince Jul 19, 2023 Accepting new patients
Community Health Center of Branch County CurrentSince Dec 1, 2022 Accepting new patients
Saint Joseph Regional Medical Center-South Bend Campus, Inc Nurse Anesthetist, Certified Registered CurrentSince Oct 10, 2023 Accepting new patients
Stat Anesthesia Specialists LTD CurrentSince May 15, 2023 Accepting new patients
Australia Anesthesia Management LLC CurrentSince Jan 16, 2025 Accepting new patients
Cameron Memorial Community Hospital, Inc CurrentSince Oct 25, 2024 Accepting new patients
Jebs Anesthesia Consultants, LLC CurrentSince Jan 1, 2023 Accepting new patients
Aas Indiana LLC Nurse Anesthetist, Certified Registered CurrentSince Feb 1, 2023 Accepting new patients
Saint Joseph Regional Medical Center-South Bend Campus, Inc. CurrentSince Oct 10, 2023 Accepting new patients
Iceland Anesthesia Management, LLC Nurse Anesthetist, Certified Registered CurrentSince Jan 1, 2022 Accepting new patients
Clinical Colleagues LLC Nurse Anesthetist, Certified Registered CurrentSince Jan 1, 2021 Accepting new patients
Stat Anesthesia Specialists, LTD. CurrentSince May 15, 2023 Accepting new patients

Locations (25 of 31)

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

306 E Maumee St
Angola, IN 46703
Phone (260) 667-5335

416 E Maumee St
Angola, IN 46703
Phone (260) 665-2141

151 Pennsylvania Pkwy
Carmel, IN 46280
Phone (317) 817-1100

505 Pintail Trce
Chesterton, IN 46304
Phone (219) 331-6731

801 S Main St
Clinton, IN 47842
Phone (765) 832-1212

1260 E State Road 205
Columbia City, IN 46725
Phone (260) 248-9000

11460 Broadway
Crown Point, IN 46307
Phone (219) 488-0155

1721 Magnavox Way
Fort Wayne, IN 46804
Phone (260) 250-0001

4105 Dicke Rd
Fort Wayne, IN 46804
Phone (260) 268-1000

7747 W Jefferson Blvd
Fort Wayne, IN 46804
Phone (260) 434-9104

1605 Winsted Dr
Goshen, IN 46526
Phone (574) 364-2970

200 High Park Ave
Goshen, IN 46526
Phone (219) 533-2141

6836 Hohman Ave
Hammond, IN 46324
Phone (219) 931-7509

1601 W Lincoln Rd
Kokomo, IN 46902
Phone (765) 453-5696

1373 N State Road 62
Madison, IN 47250
Phone (812) 801-0196

441 N Wabash Ave
Marion, IN 46952
Phone (219) 482-4577

8514 Broadway
Merrillville, IN 46410
Phone (219) 756-5010

8900 Broadway
Merrillville, IN 46410
Phone (219) 252-2173

3212 Hickory Rd
Ste A
Mishawaka, IN 46545
Phone (574) 251-0498

5215 Holy Cross Pkwy
Mishawaka, IN 46545
Phone (574) 335-2443

2401 W University Ave
Muncie, IN 47303
Phone (765) 747-3111

901 Fran Lin Pkwy
Munster, IN 46321
Phone (219) 552-8561

9200 Calumet Ave
Ste N500
Munster, IN 46321
Phone (219) 513-9955

9200 Calumet Ave
Ste S100
Munster, IN 46321
Phone (219) 576-6260

Organizations & group practices 21

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.

View all 21

Hospital & facility affiliations 9

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": "1478649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710115200000",
    "number": "1801338769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12063 LOWER HUNTINGTON RD",
            "city": "ROANOKE",
            "state": "IN",
            "postal_code": "467839667",
            "telephone_number": "251-599-6756"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5734 COVENTRY LN",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468047141",
            "telephone_number": "260-435-7973"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1373 E State Road 62",
            "address_purpose": "LOCATION",
            "city": "Madison",
            "state": "IN",
            "postal_code": "472507328",
            "country_code": "US",
            "telephone_number": "812-801-0609",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RIEBESEL",
        "first_name": "BENJAMIN",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-11-09",
        "last_updated": "2024-03-11",
        "certification_date": "2024-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IN",
            "license": "28232032A",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IN",
            "license": "28232032A",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "412840169",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100910520",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300019421",
            "state": "IN"
        }
    ],
    "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 Mar 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.