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WYATT JEFFRY GOTTSCHALK
NPI 1639989379
Physician Assistant in Fort Wayne, IN

Active since January 13, 2025PECOS Enrolled
11109 PARKVIEW PLAZA DR, FORT WAYNE, IN 46845(260) 248-7711 Get Directions Write a Review

NPPES record last updated: March 26, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Wyatt Jeffry Gottschalk NPPES

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

WYATT JEFFRY GOTTSCHALK (NPI 1639989379) is an individual physician assistant in Fort Wayne, Indiana, licensed in Indiana (10004765A) and active in the NPI registry since January 2025. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1639989379
Entity TypeIndividualMale
Primary Taxonomy363A00000X
Provider Legal NameWYATT JEFFRY GOTTSCHALK
Location Address11109 PARKVIEW PLAZA DRFort Wayne, IN 46845-1701
Mailing Address3304 Shoaff Park River DrFort Wayne, IN 46835-2035 · (260) 804-4346
Phone(260) 248-7711
Sole ProprietorNo
Enumeration DateJanuary 13, 2025
Last NPPES UpdateMarch 26, 2026
NPPES CertifiedMarch 26, 2026
✔ NPI 1639989379 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License✔ Licensed in IN · 10004765A
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
11109 PARKVIEW PLAZA DR, Fort Wayne, IN 46845
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include CareSource.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Wyatt Jeffry Gottschalk 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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 46845 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
$82.04 typical visit price
range $53.07 – $161.76
Typical copayment $20.51 (range $13.26 – $40.44)
Most-billed visit code 99203
Established Patient
$66.48 typical visit price
range $16.93 – $132.22
Typical copayment $16.62 (range $4.23 – $33.05)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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.

AHMAD ALHARIRI MD
Internal Medicine
11109 PARKVIEW PLAZA DR
FORT WAYNE, IN 46845
Allen County (260) 266-2020
DR. DANYELLE R ABER M.D.
Emergency Medicine
11109 PARKVIEW PLAZA DR
FORT WAYNE, IN 46845
Allen County (260) 266-1000
AMY SOUERS M.D.
Emergency Medicine
11109 PARKVIEW PLAZA DR
FORT WAYNE, IN 46845
Allen County (260) 266-1000
ANDY ALVAREZ HERRERA MD
Internal Medicine
11109 PARKVIEW PLAZA DR
FORT WAYNE, IN 46845
Allen County (260) 672-6620
CORISSA PIATKA
Pharmacist
11109 PARKVIEW PLAZA DR
FORT WAYNE, IN 46845
Allen County (260) 266-1000
MRS. CHRISTINA KAY FORD PHARMD
Pharmacist
11109 PARKVIEW PLAZA DR
FORT WAYNE, IN 46845
Allen County (260) 266-4400
SYDNEY NICHOLE RANZAU
Specialist/Technologist (Athletic Trainer)
11109 PARKVIEW PLAZA DR
FORT WAYNE, IN 46845
Allen County (260) 266-1000
HINA WAZIR MD
Internal Medicine
11109 PARKVIEW PLAZA DR
FORT WAYNE, IN 46845
Allen County (260) 672-6620

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 Wyatt Gottschalk's NPI number?

The NPI number for Wyatt Gottschalk is 1639989379. It was assigned to this individual provider in the NPPES registry on January 13, 2025.

Where is Wyatt Gottschalk located?

Wyatt Gottschalk practices at 11109 Parkview Plaza Dr, Fort Wayne, IN 46845. The listed phone number is (260) 248-7711.

What is Wyatt Gottschalk's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Wyatt Gottschalk enrolled in Medicare?

Yes. Wyatt Gottschalk is registered in the Medicare PECOS enrollment system.

What insurance does Wyatt Gottschalk accept?

Health plans from CareSource list Wyatt Gottschalk 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 Wyatt Gottschalk was last updated on March 26, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.