Individual provider Active NPI

Eustace S. Fernandes, MD

  • Pulmonary Disease Physician
  • Fort Wayne, IN
National Provider Identifier
1821040791
Registry record updated Sep 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
01060794A Issued in IN
Practice address
7916 W Jefferson Blvd
Fort Wayne, IN 46804-4140
Phone
(260) 432-2297
Fax
(260) 434-6481
NPI assigned
May 17, 2006
Last updated
Sep 23, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X 01060794A IN Primary

Addresses

Primary practice location

7916 W Jefferson Blvd
Fort Wayne, IN 46804-4140

Mailing address

6920 Pointe Inverness Way Ste 200
Medpartners, Attn: Barb Copeland
Fort Wayne, IN 46804-7934
Phone (260) 479-3514

Other identifiers 1

IdentifierTypeStateIssuer
200518950MedicaidIN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address eustace.fernandes@lutheranhealthnetwork.cernerdirect.com

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050620001168 IN Practitioner - Pulmonary Disease 3577508613 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary Disease
Education
Ohio State University College of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Lutheran Medical Group LLCGroup PAC ID 4981751617, 251 clinicians

Practice addresses (Care Compare)

2101 Dubois Dr
Warsaw, IN 46580-3210
Phone (260) 432-2297

235 Hauenstein Rd
Huntington, IN 46750-8803
Phone (260) 504-4110

2516 E Dupont Rd
Fort Wayne, IN 46825-1608
Phone (260) 434-6076

2520 E Dupont Rd
Dupont Hospital
Fort Wayne, IN 46825-1675
Phone (260) 432-2297

275 W 12TH St
Peru, IN 46970-1638
Phone (260) 432-2297

702 Van Buren St
Fort Wayne, IN 46802-3697
Phone (260) 425-3000

7916 W Jefferson Blvd
Fort Wayne, IN 46804-4140
Phone (260) 432-2297

7938 W Jefferson Blvd
Fort Wayne, IN 46804-4140
Phone (260) 436-8583

7950 W Jefferson Blvd
Lutheran Hospital
Fort Wayne, IN 46804-4140
Phone (260) 435-7001

7952 W Jefferson Blvd
The Orthopedic Hospital
Fort Wayne, IN 46804-4140
Phone (260) 435-2999

7956 W Jefferson Blvd
Fort Wayne, IN 46804-4140
Phone (260) 435-2836

7970 W Jefferson Blvd
Fort Wayne, IN 46804-4140
Phone (260) 435-6105

7988 W Jefferson Blvd
Fort Wayne, IN 46804-4140
Phone (260) 969-7280

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.99 of 100Reported as apm
Quality
77.41
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Lutheran Medical Group LLC Pulmonary Disease CurrentSince May 1, 2009 Accepting new patients
Lutheran Medical Group LLC CurrentSince May 1, 2009 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

353 N Oak St
Columbia City, IN 46725
Phone (260) 248-9000

2516 E DuPont Rd
Fort Wayne, IN 46825
Phone (260) 434-6076

3534 Brooklyn Ave
Fort Wayne, IN 46809
Phone (219) 478-5180

6920 Pointe Inverness Way
Ste 200
Fort Wayne, IN 46804
Phone (260) 479-3514

7900 W Jefferson Blvd
Ste 201
Fort Wayne, IN 46804
Phone (260) 969-7100

7910 W Jefferson Blvd
Ste 120
Fort Wayne, IN 46804
Phone (260) 435-7612

7916 W Jefferson Blvd
Fort Wayne, IN 46804
Phone (260) 432-2298

2003 Stults Rd
Ste 110
Huntington, IN 46750
Phone (260) 244-0238

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.

Hospital & facility affiliations 5

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": "1147824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600819200000",
    "number": "1821040791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6920 POINTE INVERNESS WAY STE 200",
            "address_2": "MEDPARTNERS, ATTN: BARB COPELAND",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468047934",
            "telephone_number": "260-479-3514",
            "fax_number": "260-479-3520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7916 W JEFFERSON BLVD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468044140",
            "telephone_number": "260-432-2297",
            "fax_number": "260-434-6481"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERNANDES",
        "first_name": "EUSTACE",
        "middle_name": "S.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-17",
        "last_updated": "2020-09-23",
        "certification_date": "2020-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "IN",
            "license": "01060794A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200518950",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "eustace.fernandes@lutheranhealthnetwork.cernerdirect.com",
            "affiliation": "N",
            "endpointDescription": "AMR direct address",
            "address_1": "7916 W Jefferson Blvd",
            "city": "Fort Wayne",
            "state": "IN",
            "country_code": "US",
            "postal_code": "468044140",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

Verify at the official NPI Registry.