MR. MARK A FISHER PA-C - NPI 1144215153 - Physician Assistant in Fort Wayne, IN

Q: What is Mark Fisher's NPI number?

The NPI number for Mark Fisher is 1144215153. It was assigned to this individual provider in the NPPES registry on September 15, 2005.

Q: What is Mark Fisher's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Q: When was this NPI record last updated?

The NPPES record for Mark Fisher was last updated on February 4, 2019. NPI Profile syncs with the weekly NPPES data releases published by CMS.

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About Mr. Mark A Fisher Pa-c NPPES

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

MR. MARK A FISHER PA-C (NPI 1144215153) is an individual medical provider in Fort Wayne, Indiana, licensed in Indiana (10000311A) and active in the NPI registry since September 2005. He is enrolled in Medicare PECOS and maintains 4 additional practice locations.

NPPES Registry Identity

NPI1144215153

Entity TypeIndividualMale

Primary Taxonomy363AM0700X

Provider Legal NameMR. MARK A FISHERCredential: PA-C

Location Address1721 MAGNAVOX WAYFort Wayne, IN 46804-1537

Mailing AddressPo Box 670Huntertown, IN 46748-0670 · (260) 748-3650 · Fax (260) 748-3651

Phone(260) 748-3650

Fax(360) 748-3651

Sole ProprietorNo

Enumeration DateSeptember 15, 2005

Last NPPES UpdateFebruary 4, 20194 updates tracked since enumeration

✔ NPI 1144215153 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363AM0700X

License✔ Licensed in IN · 10000311A

1721 MAGNAVOX WAY, Fort Wayne, IN 46804

Open in Google Maps ↗

Secondary Practice Locations 4

Location 12124 N Biomet DrWarsaw, IN 46582-7858 · Phone (260) 748-3650 · Fax (260) 748-3651

Location 26811 Lima RdFort Wayne, IN 46818-1145 · Phone (260) 748-3650 · Fax (260) 748-3651

Location 32512 E DuPont Rd Ste 200Fort Wayne, IN 46825 · Phone (260) 748-3650 · Fax (260) 748-3651

Location 41314 E 7th St Ste 201Auburn, IN 46706-2533 · Phone (260) 748-3650 · Fax (260) 748-3651

Other Identifiers 2

Medicaid300006102IN

Other931711IN · Bcbs

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mr. Mark A Fisher Pa-c is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.