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SUMMIT PLASTIC SURGERY, PC
NPI 1194701664
Plastic Surgery in Fort Wayne, IN

Active since December 16, 2005
7920 W JEFFERSON BLVD STE 200, FORT WAYNE, IN 46804(260) 490-7111(260) 490-2286 Get Directions Write a Review

NPPES record last updated: April 18, 2017. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Apr 18, 2017, Jun 20, 2016 (2 updates tracked since 2016).

About Summit Plastic Surgery, Pc NPPES

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

SUMMIT PLASTIC SURGERY, PC (NPI 1194701664) is a healthcare organization registered as a plastic surgery in Fort Wayne, Indiana and active in the NPI registry since December 2005. The organization lists Kathy Fiechter, Practice Administrator, as its authorized official.

NPPES Registry Identity

NPI1194701664
Entity TypeOrganization
Primary Taxonomy208200000X
Legal Business NameSUMMIT PLASTIC SURGERY, PC
Location Address7920 W JEFFERSON BLVD STE 200Fort Wayne, IN 46804-4166
Mailing Address7920 W Jefferson Blvd Ste 200Fort Wayne, IN 46804-4166 · (260) 490-7111 · Fax (260) 490-2286
Phone(260) 490-7111
Fax(260) 490-2286
Organization SubpartNo
Authorized OfficialKathy FiechterPractice Administrator · (260) 490-7111
Enumeration DateDecember 16, 2005
Last NPPES UpdateApril 18, 20172 updates tracked since enumeration
✔ NPI 1194701664 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPlastic SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code208200000X
Definition
A plastic surgeon deals with the repair, reconstruction or replacement of physical defects of form or function involving the skin, musculoskeletal system, craniomaxillofacial structures, hand, extremities, breast and trunk and external genitalia or cosmetic enhancement of these areas of the body. Cosmetic surgery is an essential component of plastic surgery. The plastic surgeon uses cosmetic surgical principles to both improve overall appearance and to optimize the outcome of reconstructive procedures. The surgeon uses aesthetic surgical principles not only to improve undesirable qualities of normal structures but in all reconstructive procedures as well.
7920 W JEFFERSON BLVD STE 200, Fort Wayne, IN 46804
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Other Identifiers 4

Medicaid200375290AIN
Medicaid2289394OH
Medicare PIN186080IN
Medicare PINCJ5349IN

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield.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 Plastic Surgery, Pc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Summit Plastic Surgery, PC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Matthew Shambaugh, MD
Plastic and Reconstructive Surgery
NPI 1700888617
7920 W JEFFERSON BLVD STE 200
Fort Wayne, IN 46804
(260) 490-7111
✔ PECOS✔ Accepts MedicareSame address

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

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 Summit Plastic Surgery, PC's NPI number?

The NPI number for Summit Plastic Surgery, PC is 1194701664. It was assigned to this organization in the NPPES registry on December 16, 2005.

Where is Summit Plastic Surgery, PC located?

Summit Plastic Surgery, PC is located at 7920 W Jefferson Blvd Ste 200, Fort Wayne, IN 46804. The listed phone number is (260) 490-7111.

What is Summit Plastic Surgery, PC's specialty?

The primary specialty registered for this NPI is Plastic Surgery with taxonomy code 208200000X.

Is Summit Plastic Surgery, PC enrolled in Medicare?

Yes. Summit Plastic Surgery, PC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Summit Plastic Surgery, PC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Plastic and Reconstructive Surgery) reassigns their Medicare billing to Summit Plastic Surgery, PC. 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. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Summit Plastic Surgery, PC accept?

Health plans from Anthem Blue Cross and Blue Shield list Summit Plastic Surgery, PC 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 Summit Plastic Surgery, PC was last updated on April 18, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 years 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.