Active NPI
Erin B Jungbauer, MD
- Family Medicine Physician
- Warsaw, IN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 01038535A
- Practice address
- 1210 Provident Drive
Ste B
Warsaw, IN 46580 - Phone
- (574) 268-4300
- NPI assigned
- Jun 14, 2006
- Last updated
- Dec 15, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 01038535A | IN | Primary |
Addresses
Primary practice location
1210 Provident Drive
Ste B
Warsaw, IN 46580
Mailing address
6920 Pointe Inverness Way Ste 200
Fort Wayne, IN 46804-7934
Phone (260) 479-3513
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100159270 | Medicaid | IN |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | erin.jungbauer@lutheranhealthnetwork.cernerdirect.com |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- Indiana University School of Medicine, 1989
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1205 Provident Dr a
Warsaw, IN 46580-3265
Phone (574) 269-8383
1275 Provident Dr
Warsaw, IN 46580-3265
Phone (574) 269-4026
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 90.99 of 100
- Quality
- 77.41
- Promoting interoperability
- 100
- Improvement activities
- 40
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of skin lesions | 1-10 |
| Removal or shaving of skin growth | 1-10 |
| Skin biopsy | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01038535A | IN | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kosciusko Medical Group LLC | Family Medicine | Current | Accepting new patients |
Locations
6920 Pointe Inverness Way
Ste 200
Fort Wayne, IN 46804
Phone (260) 479-3514
1001 N Main St
Ste 1
Nappanee, IN 46550
Phone (574) 372-7637
1205 Provident Dr
#A
Warsaw, IN 46580
Phone (574) 269-8383
1210 Provident Dr
Warsaw, IN 46580
Phone (219) 268-4300
1210 Provident Dr
Ste B
Warsaw, IN 46580
Phone (574) 268-4300
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.
-
- Family Medicine Physician
- Warsaw, IN
- NPI 1932349594
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Lutheran Kosciusko Hospital
- General Acute Care Hospital
- Warsaw, IN
- NPI 1164475711
-
dba Parkview Whitley Hospital
- General Acute Care Hospital
- Columbia City, IN
- NPI 1205844495
-
dba Parkview Whitley Hospital
- Land Ambulance
- Columbia City, IN
- NPI 1497764450
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150243200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1639526400000",
"number": "1972546927",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6920 POINTE INVERNESS WAY STE 200",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "468047934",
"telephone_number": "260-479-3513",
"fax_number": "260-479-3520"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1210 PROVIDENT DRIVE",
"address_2": "STE B",
"city": "WARSAW",
"state": "IN",
"postal_code": "46580",
"telephone_number": "574-268-4300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JUNGBAUER",
"first_name": "ERIN",
"middle_name": "B",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-14",
"last_updated": "2021-12-15",
"certification_date": "2021-12-15",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "IN",
"license": "01038535A",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100159270",
"state": "IN"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "erin.jungbauer@lutheranhealthnetwork.cernerdirect.com",
"affiliation": "N",
"endpointDescription": "AMR direct address",
"address_1": "1210 Provident Drive",
"address_2": "Ste B",
"city": "Warsaw",
"state": "IN",
"country_code": "US",
"postal_code": "46580",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Warsaw, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.