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GREAT LAKES PEDIATRIC SURGEONS, INC.
NPI 1669455267
Surgery - Pediatric Surgery in Fort Wayne, IN

Active since November 29, 2005
7613 W JEFFERSON BLVD STE 200, FORT WAYNE, IN 46804(260) 469-7337(260) 469-7340 Get Directions Write a Review

NPPES record last updated: March 14, 2008. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Great Lakes Pediatric Surgeons, Inc. NPPES

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

GREAT LAKES PEDIATRIC SURGEONS, INC. (NPI 1669455267) is a healthcare organization registered as a pediatric surgery in Fort Wayne, Indiana and active in the NPI registry since November 2005. The organization lists David A. Smith, President, as its authorized official.

NPPES Registry Identity

NPI1669455267
Entity TypeOrganization
Primary Taxonomy2086S0120X
Legal Business NameGREAT LAKES PEDIATRIC SURGEONS, INC.
Location Address7613 W JEFFERSON BLVD STE 200Fort Wayne, IN 46804-4182
Mailing Address7613 W Jefferson Blvd Ste 200Fort Wayne, IN 46804-4182 · (260) 469-7337 · Fax (260) 469-7340
Phone(260) 469-7337
Fax(260) 469-7340
Organization SubpartNo
Authorized OfficialDavid A. SmithPresident · (260) 469-7337
Enumeration DateNovember 29, 2005
Last NPPES UpdateMarch 14, 2008
✔ NPI 1669455267 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySurgery · Pediatric SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code2086S0120X
Definition
A surgeon with expertise in the management of surgical conditions in premature and newborn infants, children and adolescents.
7613 W JEFFERSON BLVD STE 200, Fort Wayne, IN 46804
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Other Identifiers 1

Medicare PIN220530AIN

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 Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health.Insurance ›

Other Providers at the Same Location NPPES 5

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

JOSIAH WESLEY REISH CPNP-AC
Nurse Practitioner (Pediatrics)
7613 W JEFFERSON BLVD STE 200
FORT WAYNE, IN 46804
Allen County (260) 469-7337
DR. JO A COOKE-BARBER M.D.
Surgery (Pediatric Surgery)
7613 W JEFFERSON BLVD STE 200
FORT WAYNE, IN 46804
Allen County (260) 469-7337
DR. CAREY LANE WATSON M.D.
Surgery (Pediatric Surgery)
7613 W JEFFERSON BLVD STE 200
FORT WAYNE, IN 46804
Allen County (260) 469-7337
ELIZABETH ANN MEYER PA-C
Physician Assistant
7613 W JEFFERSON BLVD STE 200
FORT WAYNE, IN 46804
Allen County (260) 469-7337
DAVID ALLEN SMITH M.D.
Surgery (Pediatric Surgery)
7613 W JEFFERSON BLVD STE 200
FORT WAYNE, IN 46804
Allen County (260) 469-7337

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 Great Lakes Pediatric Surgeons, Inc.'s NPI number?

The NPI number for Great Lakes Pediatric Surgeons, Inc. is 1669455267. It was assigned to this organization in the NPPES registry on November 29, 2005.

Where is Great Lakes Pediatric Surgeons, Inc. located?

Great Lakes Pediatric Surgeons, Inc. is located at 7613 W Jefferson Blvd Ste 200, Fort Wayne, IN 46804. The listed phone number is (260) 469-7337.

What is Great Lakes Pediatric Surgeons, Inc.'s specialty?

The primary specialty registered for this NPI is Surgery, specializing in Pediatric Surgery, with taxonomy code 2086S0120X.

What insurance does Great Lakes Pediatric Surgeons, Inc. accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan and Ambetter from Meridian list Great Lakes Pediatric Surgeons, Inc. 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 Great Lakes Pediatric Surgeons, Inc. was last updated on March 14, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.