NPIMap

Individual provider Active NPI

Henry Wu, MD

  • Nephrology Physician
  • Mishawaka, IN
National Provider Identifier
1891795670
Registry record updated Apr 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
01057570A Issued in IN
Practice address
710 Park PL
Mishawaka, IN 46545-3519
Phone
(574) 273-6787
Fax
(574) 968-7160
NPI assigned
Jul 22, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 2, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 01057570A IN Primary

Addresses

Primary practice location

710 Park PL
Mishawaka, IN 46545-3519

Mailing address

PO Box 5909
Portland, OR 97228-5909
Phone (574) 273-6767

Other identifiers 1

IdentifierTypeStateIssuer
200432430AMedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100129000757 IN Practitioner - NephrologyPractitioner - Internal Medicine 1658470729 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
Northwestern University Feinberg Medical School, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Nephrology Physicians, LLCGroup PAC ID 1850289273, 11 clinicians

Practice addresses (Care Compare)

2257 Karisa Dr
Goshen, IN 46526-6942
Phone (574) 312-6611

710 Park PL
Mishawaka, IN 46545-3519
Phone (574) 273-6767

820 Waterbury Park Dr
Elkhart, IN 46517-2358
Phone (574) 970-0777

Hospital & facility affiliations

  • FMC - Nephrology - Elkhart Dialysis facility, Elkhart, IN, CCN 152530
  • FMC - Nephrology - Goshen Dialysis facility, Goshen, IN, CCN 152643
  • Elkhart General Hospital Hospital, Elkhart, IN, CCN 150018
  • Goshen Hospital Hospital, Goshen, IN, CCN 150026
  • Memorial Hospital of South Bend Hospital, South Bend, IN, CCN 150058
  • Saint Joseph Regional Medical Center Hospital, Mishawaka, IN, CCN 150012
  • Parkview Whitley Hospital Hospital, Columbia City, IN, CCN 150101

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Nephrology Physicians LLC Nephrology CurrentSince Jul 1, 2003 Accepting new patients
Nephrology Physicians LLC CurrentSince Jul 1, 2003 Accepting new patients

Locations

820 Waterbury Park Dr
Elkhart, IN 46517
Phone (574) 970-0777

2257 Karisa Dr
Goshen, IN 46526
Phone (574) 294-4444

710 Park Pl
Ste 200
Mishawaka, IN 46545

710 Park Pl
Mishawaka, IN 46545
Phone (574) 273-6767

2855 Miller Dr
Ste 209
Plymouth, IN 46563
Phone (574) 936-2754

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: hwu17514@direct.acumenmd.com

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.

Hospital & facility affiliations 11

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": "1121990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585785600000",
    "number": "1891795670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5909",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972285909",
            "telephone_number": "574-273-6767",
            "fax_number": "574-968-7160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 PARK PL",
            "city": "MISHAWAKA",
            "state": "IN",
            "postal_code": "465453519",
            "telephone_number": "574-273-6787",
            "fax_number": "574-968-7160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WU",
        "first_name": "HENRY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-22",
        "last_updated": "2020-04-02",
        "certification_date": "2020-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "IN",
            "license": "01057570A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200432430A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mishawaka, IN

Sources for this page

Verify at the official NPI Registry.