Individual provider Active NPI

Marta E. Wrobleski, NURSE PRACTITIONER

  • Family Nurse Practitioner
  • Fort Wayne, IN
National Provider Identifier
1821646795
Registry record updated Sep 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
71009316A Issued in IN
Practice address
1717 S Calhoun St
Fort Wayne, IN 46802-5257
Phone
(260) 458-2641
Fax
(260) 458-3093
NPI assigned
Sep 3, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 71009316A IN Primary

Addresses

Primary practice location

1717 S Calhoun St
Fort Wayne, IN 46802-5257

Mailing address

2423 Lake Ridge Dr
Fort Wayne, IN 46804-3822
Phone (260) 615-9456

Other practice location 1

3350 E Paulding Rd
Fort Wayne, IN 46816-4513
Phone (260) 458-2641

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191017002063 IN Practitioner - Nurse Practitioner 8325379605 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
71009316AINMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Neighborhood Health Clinics, Inc CurrentSince Oct 4, 2019 Accepting new patients
Neighborhood Health Clinics, Inc CurrentSince Oct 4, 2019 Accepting new patients

Locations

3350 E Paulding Rd
Fort Wayne, IN 46816
Phone (260) 423-2585

1717 S Calhoun St
Fort Wayne, IN 46802
Phone (260) 458-2641

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1567468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567468800000",
    "number": "1821646795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2423 LAKE RIDGE DR",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468043822",
            "telephone_number": "260-615-9456"
        },
        {
            "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": "468025257",
            "telephone_number": "260-458-2641",
            "fax_number": "260-458-3093"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3350 E Paulding Rd",
            "address_purpose": "LOCATION",
            "city": "Fort Wayne",
            "state": "IN",
            "postal_code": "468164513",
            "country_code": "US",
            "telephone_number": "260-458-2641",
            "fax_number": "260-458-3093",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WROBLESKI",
        "first_name": "MARTA",
        "middle_name": "E.",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-03",
        "last_updated": "2019-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71009316A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

Verify at the official NPI Registry.