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LUTHERAN MEDICAL GROUP LLC
NPI 1164662805
Internal Medicine - Cardiovascular Disease in Fort Wayne, IN

Active since February 20, 2009CLIA Certified · 8 labs
7916 W JEFFERSON BLVD, FORT WAYNE, IN 46804(260) 432-2297 Get Directions Write a Review

NPPES record last updated: July 9, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jul 9, 2025, Oct 1, 2024, Mar 5, 2024 and 2 more (5 updates tracked since 2017).

About Lutheran Medical Group Llc NPPES

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

LUTHERAN MEDICAL GROUP LLC (NPI 1164662805) is a healthcare organization registered as a cardiovascular disease in Fort Wayne, Indiana and active in the NPI registry since February 2009. The organization holds 8 active CLIA laboratory certificates and lists Kristina Music, Director, Provider Enrollment, as its authorized official.

NPPES Registry Identity

NPI1164662805
Entity TypeOrganization
Primary Taxonomy207RC0000X
Legal Business NameLUTHERAN MEDICAL GROUP LLC
Location Address7916 W JEFFERSON BLVDFort Wayne, IN 46804-4140
Mailing AddressPo Box 689022Franklin, TN 37068-9022 · (888) 304-1116 · Fax (615) 465-2984
Phone(260) 432-2297
Organization SubpartNo
Authorized OfficialKristina MusicDirector, Provider Enrollment · (877) 892-9815
Enumeration DateFebruary 20, 2009
Last NPPES UpdateJuly 9, 20255 updates tracked since enumeration
NPPES CertifiedJuly 9, 2025
✔ NPI 1164662805 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 10

★ Primary SpecialtyInternal Medicine · Cardiovascular DiseaseAllopathic & Osteopathic Physicians
Taxonomy Code207RC0000X
Definition
An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms.
Also ListedInternal MedicineTaxonomy 207R00000X
Also ListedInternal Medicine · Allergy & ImmunologyTaxonomy 207RA0201X
Also ListedInternal Medicine · Clinical Cardiac ElectrophysiologyTaxonomy 207RC0001X
Also ListedInternal Medicine · Pulmonary DiseaseTaxonomy 207RP1001X
Also ListedInternal Medicine · RheumatologyTaxonomy 207RR0500X
Also ListedInternal Medicine · Sleep MedicineTaxonomy 207RS0012X
Also ListedNuclear Medicine · Nuclear CardiologyTaxonomy 207UN0901X
Also ListedPhysician AssistantTaxonomy 363A00000X
Also ListedNurse PractitionerTaxonomy 363L00000X
7916 W JEFFERSON BLVD, Fort Wayne, IN 46804
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Other Identifiers 2

Medicaid2938843OH
Medicaid200934510IN

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.Insurance ›

CLIA Laboratory Certificates CMS CLIA 8

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 15D0927945

Lutheran Medical Group LLC · Fort Wayne, IN
Active · expires Mar 20, 2028
CLIA Number15D0927945
Laboratory TypePhysician Office
Certificate Effective DateMarch 21, 2026
Certificate Expiration DateMarch 20, 2028
Laboratory DirectorDr. Vicente Rodriquez
Laboratory Phone(260) 432-2297
Laboratory LocationLutheran Medical Group LLC7916 W Jefferson Blvd, Fort Wayne, IN 46804
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 15D1103456

Lutheran Medical Group LLC · Fort Wayne, IN
Active · expires Aug 10, 2027
CLIA Number15D1103456
Laboratory TypePhysician Office
Certificate Effective DateAugust 11, 2025
Certificate Expiration DateAugust 10, 2027
Laboratory DirectorH Stephen Beyer
Laboratory Phone(260) 432-2297
Laboratory LocationLutheran Medical Group LLC7900 W Jefferson Blvd Mob-1 Ste 201, Fort Wayne, IN 46804
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 15D2061771

Lutheran Medical Group, LLC · Fort Wayne, IN
Active · expires Jul 2, 2027
CLIA Number15D2061771
Laboratory TypePhysician Office
Certificate Effective DateJuly 3, 2025
Certificate Expiration DateJuly 2, 2027
Laboratory DirectorH Stephen Beyer
Laboratory Phone(260) 432-2297
Laboratory LocationLutheran Medical Group, LLC2512 E Dupont Road, Suite 110, Fort Wayne, IN 46825
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 15D0887192

Lutheran Medical Group, LLC · Fort Wayne, IN
Active · expires Apr 12, 2028
CLIA Number15D0887192
Laboratory TypePhysician Office
Certificate Effective DateApril 13, 2026
Certificate Expiration DateApril 12, 2028
Laboratory DirectorEmmanuel C. Cabe
Laboratory Phone(260) 458-3531
Laboratory LocationLutheran Medical Group, LLC7980 W Jefferson Blvd, Fort Wayne, IN 46804
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 15D2297410

Lutheran Medical Group, LLC - Dba Lutheran Health Physicians · Fort Wayne, IN
Active · expires Jan 15, 2028
CLIA Number15D2297410
Laboratory TypePhysician Office
Certificate Effective DateJanuary 16, 2026
Certificate Expiration DateJanuary 15, 2028
Laboratory DirectorThomas Lazoff
Laboratory Phone(260) 458-3640
Laboratory LocationLutheran Medical Group, LLC - Dba Lutheran Health Physicians7956 W Jefferson Blvd, Fort Wayne, IN 46804
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 15D2135879

Lutheran Medical Group, LLC · Fort Wayne, IN
Active · expires Aug 28, 2027
CLIA Number15D2135879
Laboratory TypePhysician Office
Certificate Effective DateAugust 29, 2025
Certificate Expiration DateAugust 28, 2027
Laboratory DirectorMelissa Gephart
Laboratory Phone(260) 458-3600
Laboratory LocationLutheran Medical Group, LLC7900 West Jefferson Blvd, Suite 304, Fort Wayne, IN 46804
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 20

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

LISA R. STANLEY NP
Nurse Practitioner (Family)
7916 W JEFFERSON BLVD
FORT WAYNE, IN 46804
Allen County (260) 434-6322
STEPHEN K. REED MD
Internal Medicine (Interventional Cardiology)
7916 W JEFFERSON BLVD
FORT WAYNE, IN 46804
Allen County (260) 432-2297
ERIC M. GODDARD PA-C
Physician Assistant
7916 W JEFFERSON BLVD
FORT WAYNE, IN 46804
Allen County (260) 434-6322
JASON MICHAEL RODRIGUEZ MD
Internal Medicine (Clinical Cardiac Electrophysiology)
7916 W JEFFERSON BLVD
FORT WAYNE, IN 46804
Allen County (260) 432-2297
JEANNE M. ROWE M.D.
Internal Medicine
7916 W JEFFERSON BLVD
FORT WAYNE, IN 46804
Allen County (260) 432-2297
DR. MUZAMMIL HANIF MUSANI M.D
Internal Medicine (Interventional Cardiology)
7916 W JEFFERSON BLVD
FORT WAYNE, IN 46804
Allen County (260) 432-2297
ANN M. GRUBB PA
Physician Assistant
7916 W JEFFERSON BLVD
FORT WAYNE, IN 46804
Allen County (260) 432-2297
DR. MADHU G. JYOTHINAGARAM MD
Internal Medicine (Cardiovascular Disease)
7916 W JEFFERSON BLVD
FORT WAYNE, IN 46804
Allen County (260) 432-2297

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 Lutheran Medical Group LLC's NPI number?

The NPI number for Lutheran Medical Group LLC is 1164662805. It was assigned to this organization in the NPPES registry on February 20, 2009.

Where is Lutheran Medical Group LLC located?

Lutheran Medical Group LLC is located at 7916 W Jefferson Blvd, Fort Wayne, IN 46804. The listed phone number is (260) 432-2297.

What is Lutheran Medical Group LLC's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Cardiovascular Disease, with taxonomy code 207RC0000X.

Does Lutheran Medical Group LLC hold CLIA laboratory certificates?

Yes. 8 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

What insurance does Lutheran Medical Group LLC accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian and Anthem Blue Cross and Blue Shield list Lutheran Medical Group LLC 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.

When was this NPI record last updated?

The NPPES record for Lutheran Medical Group LLC was last updated on July 9, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.