NPIMap

Individual provider Active NPI

Robert Ervin Wilkins, MD

  • Family Medicine Physician
  • Fort Wayne, IN
National Provider Identifier
1992749485
Registry record updated Sep 16, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
01039155A Issued in IN
Practice address
750 Broadway
Suite 150
Fort Wayne, IN 46802-1402
Phone
(260) 423-2682
Fax
(260) 422-4326
NPI assigned
Jun 15, 2006
Last updated
Sep 16, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 01039155A IN Primary

Addresses

Primary practice location

750 Broadway
Suite 150
Fort Wayne, IN 46802-1402

Mailing address

750 Broadway
Suite 350
Fort Wayne, IN 46802-1411
Phone (260) 423-2682

Other identifiers 2

IdentifierTypeStateIssuer
000000088432OtherINANTHEM BC/BS
100081960BMedicaidIN

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
I20100318000424 IN Practitioner - Family Practice 6103951991 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 1975
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fort Wayne Medical Education ProgramGroup PAC ID 2860387933, 7 clinicians

Practice addresses (Care Compare)

750 Broadway
Suite 250
Fort Wayne, IN 46802-1412
Phone (260) 423-2675

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
97.04 of 100Reported as group
Quality
79.76
Promoting interoperability
94
Improvement activities
40
Cost
85.08

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Fort Wayne Medical Education Program Family Medicine CurrentSince May 1, 1996 Accepting new patients
Neighborhood Health Clinics, Inc Family Medicine CurrentSince Sep 1, 2024 Accepting new patients
Neighborhood Health Clinics, Inc CurrentSince Sep 1, 2024 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients
Super Shot Inc. Past Accepting new patients

Locations

1717 S Calhoun St
Fort Wayne, IN 46802
Phone (260) 458-2641

2434 Lake Ave
Fort Wayne, IN 46805
Phone (260) 423-2675

2827 Northgate Blvd
Fort Wayne, IN 46835
Phone (260) 492-1400

750 Broadway
Ste 150
Fort Wayne, IN 46802
Phone (260) 423-2675

750 Broadway
Ste 250
Fort Wayne, IN 46802
Phone (260) 423-2675

750 Broadway
Ste 350
Fort Wayne, IN 46802
Phone (260) 423-2675

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/19516/brand/1/csg/1/fhir/r4
  • Direct secure messaging: robert.wilkins.1@17223.direct.athenahealth.com
  • Direct secure messaging: robert.wilkins.1@19516.direct.athenahealth.com
  • Direct secure messaging: robert.wilkins@nhci.eclinicaldirectplus.com

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Towne House Retirement CommunityFort Wayne, IN, CCN 155475 Skilled nursing facility Corporate Director
Operational/Managerial Control
Adp of the SNF		 Jan 1, 2025
Jan 1, 2025
Jan 1, 2025

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

  • Bhi Senior Living, Inc.

    dba Towne House Retirement Community

    • Skilled Nursing Facility
    • Fort Wayne, IN
    • NPI 1255441663

    Adp of the SNF, Corporate Director, Operational/Managerial Control

    CMS ownership

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": "1150329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1253059200000",
    "number": "1992749485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "750 BROADWAY",
            "address_2": "SUITE 350",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468021411",
            "telephone_number": "260-423-2682",
            "fax_number": "260-422-4326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 BROADWAY",
            "address_2": "SUITE 150",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468021402",
            "telephone_number": "260-423-2682",
            "fax_number": "260-422-4326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILKINS",
        "first_name": "ROBERT",
        "middle_name": "ERVIN",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-15",
        "last_updated": "2009-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01039155A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BC/BS",
            "identifier": "000000088432",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100081960B",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

Verify at the official NPI Registry.