Individual provider Active NPI

Nicholas Leonowicz, MD

  • Emergency Medicine Physician
  • Fort Wayne, IN
National Provider Identifier
1831572254
Registry record updated Oct 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
01080188A Issued in IN
Practice address
10343 Dawsons Creek Blvd Ste a
Fort Wayne, IN 46825
Phone
(260) 206-9600
NPI assigned
Jul 2, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 9, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 01080188A IN Primary
Emergency Medicine Physician 207P00000X 4301108207 MI

Addresses

Primary practice location

10343 Dawsons Creek Blvd Ste a
Fort Wayne, IN 46825

Mailing address

10343 Dawsons Creek Blvd Ste a
Fort Wayne, IN 46825-1906
Phone (260) 203-9600

Other practice location 1

PO Box 635004
Cincinnati, OH 45263-5004
Phone (888) 952-6772

Other practice location 2

7950 W Jefferson Blvd
Fort Wayne, IN 46804-4140
Phone (260) 435-2699

Other practice location 3

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

Other identifiers 1

IdentifierTypeStateIssuer
0378205MedicaidOH

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
I20180614000865 IN Practitioner - Emergency Medicine 6305135898 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Professionals of Indiana, P.C. Emergency Medicine CurrentSince Aug 1, 2023 Accepting new patients
Innovative Hospital Care, LLC Past Accepting new patients

Locations

3700 Washington Ave
Evansville, IN 47714
Phone (812) 232-0021

7950 W Jefferson Blvd
Fort Wayne, IN 46804
Phone (260) 434-7088

2520 E DuPont Rd
Fort Wayne, IN 46825
Phone (219) 407-8000

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

85 E US Highway 6
Valparaiso, IN 46383
Phone (219) 983-5743

1900 Roosevelt Rd
Valparaiso, IN 46383
Phone (219) 263-4900

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": "1435795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759968000000",
    "number": "1831572254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10343 DAWSONS CREEK BLVD STE A",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468251906",
            "telephone_number": "260-203-9600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10343 DAWSONS CREEK BLVD STE A",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "46825",
            "telephone_number": "260-206-9600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "PO Box 635004",
            "address_purpose": "LOCATION",
            "city": "Cincinnati",
            "state": "OH",
            "postal_code": "452635004",
            "country_code": "US",
            "telephone_number": "888-952-6772",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7950 W Jefferson Blvd",
            "address_purpose": "LOCATION",
            "city": "Fort Wayne",
            "state": "IN",
            "postal_code": "468044140",
            "country_code": "US",
            "telephone_number": "260-435-2699",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "702 Van Buren St",
            "address_purpose": "LOCATION",
            "city": "Fort Wayne",
            "state": "IN",
            "postal_code": "468023697",
            "country_code": "US",
            "telephone_number": "260-425-3000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEONOWICZ",
        "first_name": "NICHOLAS",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-07-02",
        "last_updated": "2025-10-09",
        "certification_date": "2025-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IN",
            "license": "01080188A",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MI",
            "license": "4301108207",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0378205",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

Verify at the official NPI Registry.