Individual provider Active NPI

Breil Schutz, NP

  • Nurse Practitioner
  • Fort Wayne, IN
National Provider Identifier
1972914026
Registry record updated Jun 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
71004922A Issued in IN
Practice address
1721 Magnavox Way
Fort Wayne, IN 46804-1537
Phone
(260) 748-3650
NPI assigned
May 12, 2014
Last updated
Jun 1, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 11002235 FL
Nurse Practitioner 363L00000X 71004922A IN Primary

Addresses

Primary practice location

1721 Magnavox Way
Fort Wayne, IN 46804-1537

Mailing address

1721 Magnavox Way
Fort Wayne, IN 46804-1537
Phone (260) 748-3650

Other practice location 1

7950 W Jefferson Blvd
Fort Wayne, IN 46804-4140
Phone (260) 434-7088

Other identifiers 1

IdentifierTypeStateIssuer
200934510MedicaidIN

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
I20140709002192 IN Practitioner - Nurse Practitioner 6709001605 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Racc Medical Associates LLCGroup PAC ID 0648424127, 20 clinicians

Practice addresses (Care Compare)

1721 Magnavox Way
Fort Wayne, IN 46804-1537
Phone (260) 748-3650

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11002235FLMDNurse Practitioner
71004922AINMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Sound Physicians of Indiana, LLC CurrentSince Jan 13, 2019 Accepting new patients
Racc Medical Associates LLC CurrentSince Jun 1, 2023 Accepting new patients
Sound Physicians of Indiana, LLC Nurse Practitioner CurrentSince Jan 13, 2019 Accepting new patients
Hospitalist Medicine Physicians of Indiana, LLC CurrentSince Jan 12, 2019 Accepting new patients
Racc Medical Associates LLC CurrentSince Jun 1, 2023 Accepting new patients

Locations

1314 E 7th St
Ste 201
Auburn, IN 46706
Phone (260) 927-0400

601 W 2nd St
Bloomington, IN 47403
Phone (812) 353-5252

10319 Dawsons Creek Blvd
Ste F
Fort Wayne, IN 46825

1721 Magnavox Way
Fort Wayne, IN 46804
Phone (260) 250-0001

1721 Magnavox Way
#B
Fort Wayne, IN 46804
Phone (206) 748-3650

7950 W Jefferson Blvd
Fort Wayne, IN 46804
Phone (260) 434-7088

2855 Northpark Ave
Ste 105
Huntington, IN 46750

2855 Northpark Ave
Ste 106
Huntington, IN 46750

519 Professional Way
Kendallville, IN 46755
Phone (260) 347-3770

330 N Wabash Ave
Ste 410
Marion, IN 46952
Phone (765) 651-4265

5215 Holy Cross Pkwy
Mishawaka, IN 46545
Phone (574) 335-2443

1025 Manchester Ave
Ste A
Wabash, IN 46992

2124 N Biomet Dr
Warsaw, IN 46582
Phone (574) 267-2663

Organizations & group practices 5

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 5

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": "1399852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685577600000",
    "number": "1972914026",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1721 MAGNAVOX WAY",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468041537",
            "telephone_number": "260-748-3650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1721 MAGNAVOX WAY",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468041537",
            "telephone_number": "260-748-3650"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7950 W Jefferson Blvd",
            "address_purpose": "LOCATION",
            "city": "Fort Wayne",
            "state": "IN",
            "postal_code": "468044140",
            "country_code": "US",
            "telephone_number": "260-434-7088",
            "fax_number": "260-435-7394",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SCHUTZ",
        "first_name": "BREIL",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-05-12",
        "last_updated": "2023-06-01",
        "certification_date": "2023-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "11002235",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IN",
            "license": "71004922A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200934510",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

Verify at the official NPI Registry.