Matthew A Bohren (NPI# 1376945782, PAC ID# 5698097897) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PHYSICIAN ASSISTANT.
| Nation Provider ID (NPI) | 1376945782 |
| PAC ID by PECOS | 5698097897 |
| Professional Enrollment ID | I20141125000456 |
| Full Name | Matthew A Bohren |
| Organization Legal Name | FORT WAYNE ORTHOPAEDICS, LLC |
| Address |
217 W Wayne St Fort Wayne IN 46802-3605 |
| Phone Number | 2604368686 |
| Gender | M |
| Graduation Year | 2014 |
| Primary Specialty | PHYSICIAN ASSISTANT |
| Group Practice PAC ID | 7618965286 |
| Number of Group Practice Members | 47 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 150168 | THE ORTHOPAEDIC HOSPITAL OF LUTHERAN HEALTH NETWOR |
| 150017 | LUTHERAN HOSPITAL OF INDIANA |
| Address | Phone | Organization |
|---|---|---|
| 217 W Wayne St, Fort Wayne, IN 46802-3605 | 2604368686 | FORT WAYNE ORTHOPAEDICS, LLC |
| 2512 E Dupont Rd, Suite 110, Fort Wayne, IN 46825-1609 | 2604368686 | FORT WAYNE ORTHOPAEDICS, LLC |
| 7601 W Jefferson Blvd, Fort Wayne, IN 46804-4133 | 2604368686 | FORT WAYNE ORTHOPAEDICS, LLC |
| 7631 W Jefferson Blvd, The Imaging Center, Fort Wayne, IN 46804-4133 | 2604367770 | FORT WAYNE ORTHOPAEDICS, LLC |
| Organization Legal Name | FORT WAYNE ORTHOPAEDICS, LLC |
| Physicians | 49 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Phillip C Penny | Orthopedic Surgery | Fort Wayne Orthopaedics, LLC | 605 N Walnut St, North Manchester, IN 46962-1857 |
| Abigail Vanlaningham | Physician Assistant | Fort Wayne Orthopaedics, LLC | 3270 Intertech Dr, Angola, IN 46703-7325 |
| Hope E Royce | Nurse Practitioner | Fort Wayne Orthopaedics, LLC | 7601 W Jefferson Blvd, Fort Wayne, IN 46804-4133 |
| Gage M Caudell | Podiatry | Fort Wayne Orthopaedics, LLC | 208 N Columbus St, Hicksville, OH 43526-1250 |
| Brian T Laursen | Physician Assistant | Fort Wayne Orthopaedics, LLC | 701 Orthopaedic Dr, Suite 100, Warsaw, IN 46582-3905 |
| Jonathan D Detommaso | Podiatry | Fort Wayne Orthopaedics, LLC | 7601 W Jefferson Blvd, Fort Wayne, IN 46804-4133 |
| Ian R Nelson | Orthopedic Surgery | Fort Wayne Orthopaedics, LLC | 2512 E Dupont Rd, Suite 110, Fort Wayne, IN 46825-1609 |
| John Paul Magno Manalo | Orthopedic Surgery | Fort Wayne Orthopaedics, LLC | 7601 W Jefferson Blvd, Fort Wayne, IN 46804-4133 |
| Alex Villavicencio | Nurse Practitioner | Fort Wayne Orthopaedics, LLC | 7601 W Jefferson Blvd, Fort Wayne, IN 46804-4133 |
| Carolyn Hanrahan | Physician Assistant | Fort Wayne Orthopaedics, LLC | 7601 W Jefferson Blvd, Fort Wayne, IN 46804-4133 |
| Street Address |
217 W WAYNE ST |
| City | FORT WAYNE |
| State | IN |
| Zip | 46802-3605 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Joshua M Winters | Orthopedic Surgery | Fort Wayne Orthopaedics, LLC | 217 W Wayne St, Fort Wayne, IN 46802-3605 |
| Benjamin M Hicks | Orthopedic Surgery | Fort Wayne Orthopaedics, LLC | 217 W Wayne St, Fort Wayne, IN 46802-3605 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Nikkiya Fraser | Infectious Disease | Lutheran Medical Group LLC | 700 Broadway, Fort Wayne, IN 46802-1402 |
| Tara J Little | Nurse Practitioner | Associated Surgeons and Physicians LLC | 700 Broadway, Fl 2, Fort Wayne, IN 46802-1402 |
| Debra K Brandenberger | Nurse Practitioner | Associated Surgeons and Physicians LLC | 700 Broadway, Fl 2, Fort Wayne, IN 46802-1402 |
| Melissa K Gephart | Nurse Practitioner | Lutheran Medical Group LLC | 700 Broadway, Fort Wayne, IN 46802-1402 |
| April Renee Morrison | Infectious Disease | Lutheran Medical Group LLC | 700 Broadway, Fort Wayne, IN 46802-1402 |
| Dedrick K. Bowe | Pulmonary Disease | Lutheran Medical Group LLC | 700 Broadway, Fort Wayne, IN 46802-1402 |
| Maryann Meo | General Surgery | Lutheran Medical Group LLC | 700 Broadway, Fort Wayne, IN 46802-1402 |
| Carrie B Price | Nurse Practitioner | Associated Surgeons and Physicians LLC | 700 Broadway, Fl 2, Fort Wayne, IN 46802-1402 |
| William A Wood | Plastic and Reconstructive Surgery | Lutheran Medical Group LLC | 700 Broadway, Fort Wayne, IN 46802-1402 |
| Glenn Alan Glogas | Undersea and Hyperbaric Medicine | Associated Surgeons and Physicians LLC | 700 Broadway, Fl 2, Fort Wayne, IN 46802-1402 |
| Find all physicians in zip 46802 | |||
| City | FORT WAYNE |
| Zip Code | 46802 |
| Specialty | PHYSICIAN ASSISTANT |
| City + Specialty | FORT WAYNE + PHYSICIAN ASSISTANT |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.