Individual provider Active NPI

Michael John Dewinter, MSW, LCSW

  • Clinical Social Worker
  • Fort Wayne, IN
National Provider Identifier
1841889011
Registry record updated Oct 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
34009074A Issued in IN
Practice address
4402 E State Blvd
Fort Wayne, IN 46815-6917
Phone
(260) 425-5600
Fax
(260) 425-5605
NPI assigned
Jan 13, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 34009074A IN Primary

Addresses

Primary practice location

4402 E State Blvd
Fort Wayne, IN 46815-6917

Mailing address

11109 Parkview Plaza Dr # 117
Fort Wayne, IN 46845-1701

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210114000893 IN Practitioner - Clinical Social Worker 0143633032 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Parkview Health System IncGroup PAC ID 2163336967, 1,350 clinicians

Practice addresses (Care Compare)

512 N Professional Way
Kendallville, IN 46755-2927
Phone (260) 347-8556

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Parkview Health System, Inc. CurrentSince Jul 18, 2023 Accepting new patients
Bowen Health Inc CurrentSince Jan 4, 2021 Accepting new patients
Parkview Health System Inc Current Accepting new patients
Bowen Health Inc CurrentSince Jan 4, 2021 Accepting new patients

Locations

11109 Parkview Plaza Dr
#117
Fort Wayne, IN 46845
Phone (260) 266-6012

4402 E State Blvd
Fort Wayne, IN 46815
Phone (260) 425-5500

2100 Goshen Rd
Fort Wayne, IN 46808
Phone (260) 471-3500

512 Professional Way
Kendallville, IN 46755
Phone (260) 347-8556

850 N Harrison St
Warsaw, IN 46580
Phone (219) 267-7169

2621 E Jefferson St
Warsaw, IN 46580
Phone (574) 269-0573

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1610496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730160000000",
    "number": "1841889011",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11109 PARKVIEW PLAZA DR # 117",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468451701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4402 E STATE BLVD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468156917",
            "telephone_number": "260-425-5600",
            "fax_number": "260-425-5605"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEWINTER",
        "first_name": "MICHAEL",
        "middle_name": "JOHN",
        "credential": "MSW, LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-01-13",
        "last_updated": "2024-10-29",
        "certification_date": "2024-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34009074A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

Verify at the official NPI Registry.