Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

MARY CASEY CHRISTOPHERSEN NP
NPI 1669061289
Nurse Practitioner in Fort Wayne, IN

Q: What is Mary Christophersen's NPI number?

The NPI number for Mary Christophersen is 1669061289. It was assigned to this individual provider in the NPPES registry on January 18, 2021. The provider is also known as Mary Casey Niezer.

Q: What is Mary Christophersen's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Active since January 18, 2021PECOS Enrolled

6507 E STATE BLVD, FORT WAYNE, IN 46815(260) 486-3300(260) 486-3600 Get Directions Write a Review

NPPES record last updated: September 3, 2026. Verified against the NPPES registry weekly; last sync: September 06, 2026.

Record update history: Sep 3, 2026, Jan 18, 2021 (2 updates tracked since 2021).

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About Mary Casey Christophersen Np NPPES

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

MARY CASEY CHRISTOPHERSEN NP (NPI 1669061289) is an individual nurse practitioner in Fort Wayne, Indiana, licensed in Indiana (71011222A) and active in the NPI registry since January 2021. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1669061289

Entity TypeIndividualFemale

Primary Taxonomy363L00000X

Provider Legal NameMARY CASEY CHRISTOPHERSENCredential: NP

Location Address6507 E STATE BLVDFort Wayne, IN 46815-7026

Mailing Address11109 Parkview Plaza Dr # 117Fort Wayne, IN 46845-1701

Phone(260) 486-3300

Fax(260) 486-3600

Sole ProprietorNo

Enumeration DateJanuary 18, 2021

Last NPPES UpdateSeptember 3, 20262 updates tracked since enumeration

NPPES CertifiedSeptember 3, 2026

✔ NPI 1669061289 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363L00000X

License✔ Licensed in IN · 71011222A

Definition

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

Also ListedRegistered NurseTaxonomy 163W00000X · License 28234514A (IN)

6507 E STATE BLVD, Fort Wayne, IN 46815

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Other Names 1

Former Name (1)Mary Casey Niezer

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 ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mary Casey Christophersen Np 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 46815 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

$94.22 typical visit price

range $16.93 – $132.22

Typical copayment $23.55 (range $4.23 – $33.05)

Most-billed visit code 99214

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 7

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

COURTNEY MARIE JACKSON MD

Family Medicine