Individual provider Active NPI

Geoffrey Bratsberg, PA-C

  • Physician Assistant
  • Fort Wayne, IN
National Provider Identifier
1962851816
Registry record updated Apr 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
10002051A Issued in IN
Practice address
11109 Parkview Plaza Dr
Fort Wayne, IN 46845-1701
Phone
(260) 373-4000
Fax
(260) 482-4442
NPI assigned
Jun 10, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 50.008510RX OH
Physician Assistant 363A00000X 10002051A IN Primary

Addresses

Primary practice location

11109 Parkview Plaza Dr
Fort Wayne, IN 46845-1701

Mailing address

608 Union Chapel Rd
Fort Wayne, IN 46845-9357
Phone (260) 482-4440

Other practice location 1

442 W High St Ste 3
Bryan, OH 43506-1681
Phone (419) 636-4517

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN, OH2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20160707002252 IN Practitioner - Physician Assistant 3173815339 Reassigns benefits to 1 organization
I20241122000397 OH Practitioner - Physician Assistant 3173815339 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Midwest Community Health Associates, Inc.Group PAC ID 0941114250, 100 clinicians

Practice addresses (Care Compare)

433 W High St
Bryan, OH 43506-1690
Phone (419) 630-2028

442 W High St
Bryan, OH 43506-1681
Phone (260) 266-8210

Hospital & facility affiliations

  • Community Hospitals and Wellness Centers Hospital, Bryan, OH, CCN 360121

Merit-based Incentive Payment System (MIPS)

Final score
95.38 of 100Reported as group
Quality
87.23
Promoting interoperability
100
Improvement activities
40
Cost
83.74

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
10002051AINMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Midwest Community Health Associates, Inc. CurrentSince Nov 18, 2024 Accepting new patients
Midwest Community Health Associates, Inc. CurrentSince Nov 18, 2024 Accepting new patients
Interventional Pain Consultants, LLC PastSince Feb 20, 2009 Accepting new patients

Locations

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

11109 Parkview Plaza Dr
Fort Wayne, IN 46845
Phone (260) 266-2020

2200 Randallia Dr
Fort Wayne, IN 46805
Phone (260) 373-4000

433 W High St
Bryan, OH 43506
Phone (419) 636-1131

442 W High St
Bryan, OH 43506
Phone (260) 266-8210

442 W High St
Ste 3
Bryan, OH 43506
Phone (419) 633-4174

Interoperability endpoints

  • Direct secure messaging: gbratsberg97272@direct.parkviewexchange.com

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 and National Provider Directory roles.

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": "1465516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775433600000",
    "number": "1962851816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "608 UNION CHAPEL RD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468459357",
            "telephone_number": "260-482-4440",
            "fax_number": "260-482-4442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11109 PARKVIEW PLAZA DR",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468451701",
            "telephone_number": "260-373-4000",
            "fax_number": "260-482-4442"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "442 W High St Ste 3",
            "address_purpose": "LOCATION",
            "city": "Bryan",
            "state": "OH",
            "postal_code": "435061681",
            "country_code": "US",
            "telephone_number": "419-636-4517",
            "fax_number": "419-636-6438",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRATSBERG",
        "first_name": "GEOFFREY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-10",
        "last_updated": "2026-04-06",
        "certification_date": "2026-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50.008510RX",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IN",
            "license": "10002051A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

Verify at the official NPI Registry.