Individual provider Active NPI

Nicholas Dutro, M.D.

  • Family Medicine Physician
  • Fort Wayne, IN
National Provider Identifier
1992024327
Registry record updated Oct 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
01072528A Issued in IN
Practice address
8911 Liberty Mills Rd
Fort Wayne, IN 46804-6311
Phone
(260) 373-9465
NPI assigned
May 25, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X 01072528A IN Primary

Addresses

Primary practice location

8911 Liberty Mills Rd
Fort Wayne, IN 46804-6311

Mailing address

11109 Parkview Plaza Dr # 117
Fort Wayne, IN 46845-1701
Phone (260) 266-6013

Other practice location 1

5550 Wyoming Blvd NE
Albuquerque, NM 87109-3167
Phone (505) 462-6600

Electronic endpoints 3

TypeEndpointUseAffiliation
FHIR URL https://epicprod-mobile.parkview.com/FHIR/api/FHIR/DSTU2/
Direct Messaging Address ndutro6872@Direct.Parkviewexchange.com
FHIR URL https://epicprod-mobile.parkview.com/FHIR/api/FHIR/R4/

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130925000761 IN Practitioner - Family Practice 3072757475 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Parkview Health System IncGroup PAC ID 2163336967, 1,350 clinicians

Practice addresses (Care Compare)

8911 Liberty Mills Rd
Fort Wayne, IN 46804-6311
Phone (260) 373-9465

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.53 of 100Reported as group
Quality
70
Promoting interoperability
100
Improvement activities
40
Cost
75.11

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions14
Removal or shaving of skin growth1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Parkview Health System Inc Family Medicine CurrentSince Aug 1, 2013 Accepting new patients

Locations

817 Trail Ridge Rd
Albion, IN 46701
Phone (260) 373-9590

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

3702 New Vision Dr
Bldg B
Fort Wayne, IN 46845
Phone (260) 266-8210

8911 Liberty Mills Rd
Fort Wayne, IN 46804
Phone (260) 373-5419

3926 New Vision Dr
Bldg H
Fort Wayne, IN 46845

240 S Jefferson St
Ste B
Huntington, IN 46750
Phone (219) 259-0000

Interoperability endpoints

  • Direct secure messaging: ndutro6872@direct.parkviewexchange.com

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 and National Provider Directory roles.

Hospital & facility affiliations 4

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": "1274745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666224000000",
    "number": "1992024327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11109 PARKVIEW PLAZA DR # 117",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468451701",
            "telephone_number": "260-266-6013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8911 LIBERTY MILLS RD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468046311",
            "telephone_number": "260-373-9465"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5550 Wyoming Blvd NE",
            "address_purpose": "LOCATION",
            "city": "Albuquerque",
            "state": "NM",
            "postal_code": "871093167",
            "country_code": "US",
            "telephone_number": "505-462-6600",
            "fax_number": "505-462-6641",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DUTRO",
        "first_name": "NICHOLAS",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-05-25",
        "last_updated": "2022-10-20",
        "certification_date": "2022-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01072528A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicprod-mobile.parkview.com/FHIR/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "8911 Liberty Mills Rd",
            "city": "Fort Wayne",
            "state": "IN",
            "country_code": "US",
            "postal_code": "468046311",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ndutro6872@Direct.Parkviewexchange.com",
            "affiliation": "N",
            "address_1": "8911 Liberty Mills Rd",
            "city": "Fort Wayne",
            "state": "IN",
            "country_code": "US",
            "postal_code": "468046311",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicprod-mobile.parkview.com/FHIR/api/FHIR/R4/",
            "affiliation": "N",
            "address_1": "8911 Liberty Mills Rd",
            "city": "Fort Wayne",
            "state": "IN",
            "country_code": "US",
            "postal_code": "468046311",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

Verify at the official NPI Registry.