SUMMIT PAIN MANAGEMENT
NPI 1184976136
Physical Medicine & Rehabilitation in Fort Wayne, IN

Active since October 15, 2012CLIA 15D2066048 · Certificate of Compliance
1721 MAGNAVOX WAY, FORT WAYNE, IN 46804(260) 748-3650(260) 748-3651 Get Directions Write a Review

NPPES record last updated: November 5, 2024. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Nov 5, 2024, Nov 7, 2022, Sep 2, 2022 and 6 more (9 updates tracked since 2017).

About Summit Pain Management NPPES

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

SUMMIT PAIN MANAGEMENT (NPI 1184976136) is a healthcare organization registered as a physical medicine & rehabilitation in Fort Wayne, Indiana and active in the NPI registry since October 2012. The organization holds a CLIA Certificate of Compliance certificate valid through January 15, 2028, maintains 4 additional practice locations, and lists Daniel C Roth, Owner, as its authorized official.

NPPES Registry Identity

NPI1184976136
Entity TypeOrganization
Primary Taxonomy208100000X
Legal Business NameRACC MEDICAL ASSOCIATES LLC
Location Address1721 MAGNAVOX WAYFort Wayne, IN 46804-1537
Mailing Address1721 Magnavox Way, Ste BFort Wayne, IN 46804-1537 · (260) 748-3650 · Fax (260) 748-3651
Fax(260) 748-3651
Organization SubpartNo
Authorized OfficialDaniel C RothOwner · (260) 748-3650
Enumeration DateOctober 15, 2012
Last NPPES UpdateNovember 5, 20249 updates tracked since enumeration
NPPES CertifiedNovember 5, 2024
✔ NPI 1184976136 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

★ Primary SpecialtyPhysical Medicine & RehabilitationAllopathic & Osteopathic Physicians
Taxonomy Code208100000X
Definition
Physical medicine and rehabilitation, also referred to as rehabilitation medicine, is the medical specialty concerned with diagnosing, evaluating, and treating patients with physical disabilities. These disabilities may arise from conditions affecting the musculoskeletal system such as neck and back pain, sports injuries, or other painful conditions affecting the limbs, such as carpal tunnel syndrome. Alternatively, the disabilities may result from neurological trauma or disease such as spinal cord injury, head injury or stroke. A physician certified in physical medicine and rehabilitation is often called a physiatrist. The primary goal of the physiatrist is to achieve maximal restoration of physical, psychological, social and vocational function through comprehensive rehabilitation. Pain management is often an important part of the role of the physiatrist. For diagnosis and evaluation, a physiatrist may include the techniques of electromyography to supplement the standard history, physical, x-ray and laboratory examinations. The physiatrist has expertise in the appropriate use of therapeutic exercise, prosthetics (artificial limbs), orthotics and mechanical and electrical devices.
Also ListedAnesthesiology · Pain MedicineTaxonomy 207LP2900X
Also ListedDurable Medical Equipment & Medical SuppliesTaxonomy 332B00000X
1721 MAGNAVOX WAY, Fort Wayne, IN 46804

Other Names 1

Doing Business AsSummit Pain Management

Secondary Practice Locations 4

Location 16811 Lima RdFort Wayne, IN 46818-1145 · Phone (260) 748-3650 · Fax (260) 748-3651
Location 21314 E 7th St Ste 201Auburn, IN 46706-2533 · Phone (260) 748-3650 · Fax (260) 748-3651
Location 3330 N Wabash Ave Ste 410Marion, IN 46952-2782 · Phone (260) 748-3650 · Fax (260) 748-3651
Location 42124 Biomet DriveWarsaw, IN 46582-7858 · Phone (260) 748-3650 · Fax (260) 748-3651

Other Identifiers 1

Medicaid300038645IN

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

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Summit Pain Management is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

15

Medicare enrollment records show 15 clinicians reassign Medicare billing to Summit Pain Management, which bills Medicare for the services they deliver. Of these, 7 practice at this address and 9 within 10 miles. They are listed nearest first.

Clinicians by Medicare Specialty 3

Nurse Practitioner9
Anesthesiology5
Physical Medicine and Rehabilitation1

Clinicians, nearest first (15)

Anesthesiology
NPI 1053579151
1721 MAGNAVOX WAY
Fort Wayne, IN 46804
(260) 748-3650
✔ PECOS✔ Accepts MedicareSame address
Nurse Practitioner
NPI 1699423848
1721 MAGNAVOX WAY STE B
Fort Wayne, IN 46804
(260) 748-3650
✔ PECOS✔ Accepts MedicareSame address
Nurse Practitioner
NPI 1326534132
1721 MAGNAVOX WAY STE B
Fort Wayne, IN 46804
(260) 748-3650
✔ PECOS✔ Accepts MedicareSame address
Nurse Practitioner
NPI 1437700101
1721 MAGNAVOX
Fort Wayne, IN 46804
(260) 748-3650
✔ PECOS✔ Accepts MedicareSame address
Physical Medicine and Rehabilitation
NPI 1861687923
1721 MAGNAVOX WAY
Fort Wayne, IN 46804
(260) 748-3650
✔ PECOS✔ Accepts MedicareSame address
Nurse Practitioner
NPI 1972914026
1721 MAGNAVOX WAY
Fort Wayne, IN 46804
(260) 748-3650
✔ PECOS✔ Accepts MedicareSame address
Nurse Practitioner
NPI 1780261321
1721 MAGNAVOX WAY
Fort Wayne, IN 46804
(260) 748-3650
✔ PECOS✔ Accepts MedicareSame address
Nurse Practitioner
NPI 1093256950
7601 W JEFFERSON BLVD
Fort Wayne, IN 46804
(260) 436-8686
✔ PECOS✔ Accepts Medicare2.2 mi
Anesthesiology
NPI 1699930990
10315 DAWSONS CREEK BLVD STE AB
Fort Wayne, IN 46825
(260) 436-7875
✔ PECOS✔ Accepts Medicare8.4 mi
Nurse Practitioner
NPI 1821606500
11104 PARKVIEW CIRCLE DR STE 110
Fort Wayne, IN 46845
(260) 425-6780
✔ PECOS✔ Accepts Medicare10 mi
Anesthesiology
NPI 1770711095
11141 PARKVIEW PLAZA DR STE 200
Fort Wayne, IN 46845
(260) 425-6030
✔ PECOS✔ Accepts Medicare10 mi
Anesthesiology
NPI 1467435305
4728 VANDOLAH RD
Leo, IN 46765
(260) 241-4501
✔ PECOS✔ Accepts Medicare13 mi
Nurse Practitioner
NPI 1538515515
441 N WABASH AVE
Marion, IN 46952
(765) 662-6000
✔ PECOS✔ Accepts Medicare42 mi
Anesthesiology
NPI 1912965849
3570 N BRIARWOOD LN
Muncie, IN 47304
(765) 213-6373
✔ PECOS✔ Accepts Medicare60 mi
Nurse Practitioner
NPI 1952023996
2200 169TH ST
Hammond, IN 46323
(219) 989-2400
✔ PECOS✔ Accepts Medicare122 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA

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 Compliance 15D2066048

Summit Pain Management · Fort Wayne, IN
Active · expires Jan 15, 2028
CLIA Number15D2066048
Laboratory TypePhysician Office
Certificate Effective DateJanuary 16, 2026
Certificate Expiration DateJanuary 15, 2028
Laboratory DirectorQing Li
Laboratory Phone(260) 748-3650
Laboratory LocationSummit Pain Management1721 Magnavox Way Suite B, Fort Wayne, IN 46804
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

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 Racc Medical Associates LLC's NPI number?

The NPI number for Racc Medical Associates LLC is 1184976136. It was assigned to this organization in the NPPES registry on October 15, 2012. The provider is doing business as Summit Pain Management.

Where is Racc Medical Associates LLC located?

Racc Medical Associates LLC is located at 1721 Magnavox Way, Fort Wayne, IN 46804. The listed phone number is (260) 748-3650.

What is Racc Medical Associates LLC's specialty?

The primary specialty registered for this NPI is Physical Medicine & Rehabilitation with taxonomy code 208100000X.

Is Racc Medical Associates LLC enrolled in Medicare?

Yes. Racc Medical Associates LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Racc Medical Associates LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 15 clinicians in 3 Medicare specialties reassign their Medicare billing to Racc Medical Associates LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Nurse Practitioner (9), Anesthesiology (5) and Physical Medicine and Rehabilitation (1). Of these, 7 practice at this address and 9 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Racc Medical Associates LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Compliance (number 15D2066048) is associated with this NPI, valid through January 15, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Racc Medical Associates LLC accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Anthem Blue Cross and Blue Shield and CareSource list Racc Medical Associates 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 Racc Medical Associates LLC was last updated on November 5, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 23 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.