Individual provider Active NPI

Nathanial David Schaefer

  • Gerontology Nurse Practitioner
  • Fort Wayne, IN
National Provider Identifier
1871200360
Registry record updated Nov 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
2022060453 Issued in IN
Practice address
6326 Constitution Dr
Fort Wayne, IN 46804-1518
Phone
(260) 271-9821
NPI assigned
Nov 3, 2022
Last updated
Nov 3, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 3, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 2022060453 IN Primary

Addresses

Primary practice location

6326 Constitution Dr
Fort Wayne, IN 46804-1518

Mailing address

15023 Cypress Pointe Dr
Fort Wayne, IN 46818-9256
Phone (260) 271-9821

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230119001001 IN Practitioner - Nurse Practitioner 0840661401 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
RP Care LLCGroup PAC ID 9234424813, 31 clinicians

Practice addresses (Care Compare)

6326 Constitution Dr
Fort Wayne, IN 46804-1518
Phone (260) 515-3275

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
22.87 of 100Reported as individual
Quality
0
Promoting interoperability
0
Improvement activities
0
Cost
76.24

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2022060453INMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
RP Care LLC Multi-Specialty CurrentSince Jan 4, 2023 Accepting new patients

Locations

6326 Constitution Dr
Fort Wayne, IN 46804
Phone (260) 515-3275

Organizations & group practices 1

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 1

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": "1667433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667433600000",
    "number": "1871200360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15023 CYPRESS POINTE DR",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468189256",
            "telephone_number": "260-271-9821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6326 CONSTITUTION DR",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468041518",
            "telephone_number": "260-271-9821"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHAEFER",
        "first_name": "NATHANIAL",
        "middle_name": "DAVID",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-11-03",
        "last_updated": "2022-11-03",
        "certification_date": "2022-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "IN",
            "license": "2022060453",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

Verify at the official NPI Registry.