DOROTHEA ADDO MD
NPI 1063478360
Internal Medicine in Fort Wayne, IN

Active since April 25, 2006PECOS EnrolledAccepts Medicare Assignment
87.95/100
CMS Quality Rating
2622 LAKE AVE, FORT WAYNE, IN 46805(260) 425-3100 Get Directions Write a Review

NPPES record last updated: August 29, 2023. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Aug 29, 2023, Oct 13, 2020 (2 updates tracked since 2020).

About Dorothea Addo Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DOROTHEA ADDO MD (NPI 1063478360) is an individual internal medicine provider in Fort Wayne, Indiana, licensed in Indiana (01045551A) and active in the NPI registry since April 2006. She is enrolled in Medicare PECOS, is affiliated with Lutheran Hospital Of Indiana, and is a graduate of Other (1988).

NPPES Registry Identity

NPI1063478360
Entity TypeIndividualFemale
Primary Taxonomy207R00000X
Provider Legal NameDOROTHEA ADDOCredential: MD
Location Address2622 LAKE AVEFort Wayne, IN 46805-5410
Mailing Address2622 Lake AveFort Wayne, IN 46805-5410 · (260) 425-3100 · Fax (260) 425-3604
Sole ProprietorNo
Medical School CMSOtherGraduated 1988
Enumeration DateApril 25, 2006
Last NPPES UpdateAugust 29, 20232 updates tracked since enumeration
NPPES CertifiedAugust 29, 2023
NPI 1063478360 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License Licensed in IN · 01045551A
Definition

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

2622 LAKE AVE, Fort Wayne, IN 46805

Other Identifiers 1

Medicaid200163320IN

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Dorothea Addo Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID1759426927
PECOS Enrollment IDI20100227000106
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 5

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
190 services61 patients
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439
An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.
38 services38 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
33 services20 patients
Annual depression screening, 5 to 15 minutes G0444
An annual depression screening is a short, routine evaluation to check for signs of depression. It involves answering a series of questions about your feelings, thoughts, and behaviors. The process takes about 15 minutes and helps detect depression early for better management.
28 services28 patients
Administration of influenza virus vaccine G0008
The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.
13 services13 patients

Hospital Affiliations CMS Care Compare 4

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Lutheran Hospital Of Indiana

Acute Care Hospitals · Fort Wayne, IN
3/5 CMS rating
OwnershipProprietary
CMS Certification Number150017
Location7950 W Jefferson BlvdFort Wayne, IN 46804 · Allen County
Emergency services Birthing friendly

Parkview Regional Medical Center

Acute Care Hospitals · Fort Wayne, IN
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number150021
Location11109 Parkview Plaza DriveFort Wayne, IN 46845 · Allen County
Emergency services Birthing friendly

St Joseph Health System, LLC

Acute Care Hospitals · Fort Wayne, IN
OwnershipProprietary
CMS Certification Number150047
Location702 Van Buren StreetFort Wayne, IN 46802 · Allen County
Emergency services

Dupont Hospital LLC

Acute Care Hospitals · Fort Wayne, IN
4/5 CMS rating
OwnershipProprietary
CMS Certification Number150150
Location2520 E Dupont RdFort Wayne, IN 46825 · Allen County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 46805 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$122.49 typical visit price
range $53.07 – $161.76
Typical copayment $30.62 (range $13.26 – $40.44)
Most-billed visit code 99204
Established Patient
$94.22 typical visit price
range $16.93 – $132.22
Typical copayment $23.55 (range $4.23 – $33.05)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

87.95/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality74.04
Promoting Interoperability100
Improvement Activities40

Referred Medical Equipment & Supplies CMS DME claims 5

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
10 suppliers41 claims127 services$5.73 avg. paid by Medicare
Lancets, per box of 100 A4259
DME-Medical/Surgical Supplies · category DA000N
9 suppliers22 claims34 services$0.91 avg. paid by Medicare
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg J7613
DME-Drugs Administered Through DME · category DG006N
4 suppliers17 claims4,260 services$0.03 avg. paid by Medicare
Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service K0553
DME-Other DME · category DE017N
4 suppliers13 claims13 services$196.70 avg. paid by Medicare
Pharmacy dispensing fee for inhalation drug(s); per 30 days Q0513
DME-Other DME · category DE000N
4 suppliers17 claims17 services$24.57 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 13

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Occupational Therapist
2622 LAKE AVE
FORT WAYNE, IN 46805
Nurse Practitioner
2622 LAKE AVE
FORT WAYNE, IN 46805
Psychiatry & Neurology (Neurology)
2622 LAKE AVE
FORT WAYNE, IN 46805
Speech-Language Pathologist
2622 LAKE AVE
FORT WAYNE, IN 46805
Internal Medicine (Gastroenterology)
2622 LAKE AVE
FORT WAYNE, IN 46805
Internal Medicine (Cardiovascular Disease)
2622 LAKE AVE
FORT WAYNE, IN 46805
Pediatrics
2622 LAKE AVE
FORT WAYNE, IN 46805
Family Medicine
2622 LAKE AVE
FORT WAYNE, IN 46805

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Dorothea Addo's NPI number?

The NPI number for Dorothea Addo is 1063478360. It was assigned to this individual provider in the NPPES registry on April 25, 2006.

Where is Dorothea Addo located?

Dorothea Addo practices at 2622 Lake Ave, Fort Wayne, IN 46805. The listed phone number is (260) 425-3100.

What is Dorothea Addo's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Dorothea Addo enrolled in Medicare?

Yes. Dorothea Addo is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Dorothea Addo accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian and Anthem Blue Cross and Blue Shield list Dorothea Addo as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Dorothea Addo affiliated with any hospitals?

According to CMS data, Dorothea Addo is affiliated with Lutheran Hospital Of Indiana, Parkview Regional Medical Center, St Joseph Health System, LLC and Dupont Hospital LLC.

When was this NPI record last updated?

The NPPES record for Dorothea Addo was last updated on August 29, 2023. NPI Profile syncs with the weekly NPPES data releases published by CMS.