DR. NICHOLAS LEE NUSSBAUM M.D.
NPI 1720107824
Family Medicine in Fort Wayne, IN

Q: What is Nicholas Nussbaum's NPI number?

The NPI number for Nicholas Nussbaum is 1720107824. It was assigned to this individual provider in the NPPES registry on March 28, 2007.

Q: What is Nicholas Nussbaum's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Q: When was this NPI record last updated?

The NPPES record for Nicholas Nussbaum was last updated on April 3, 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.

Active since March 28, 2007PECOS EnrolledAccepts Medicare Assignment

1819 CAREW ST, FORT WAYNE, IN 46805(260) 373-7770(260) 373-7775 Get Directions Write a Review

NPPES record last updated: April 3, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Dr. Nicholas Lee Nussbaum M.d. NPPES

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

DR. NICHOLAS LEE NUSSBAUM M.D. (NPI 1720107824) is an individual family medicine provider in Fort Wayne, Indiana, licensed in Indiana (01063067A) and active in the NPI registry since March 2007. He is enrolled in Medicare PECOS, maintains a secondary practice location in Monroe, and is a graduate of Indiana University School Of Medicine (2005).

NPPES Registry Identity

NPI1720107824

Entity TypeIndividualMale

Primary Taxonomy207Q00000X

Provider Legal NameDR. NICHOLAS LEE NUSSBAUMCredential: M.D.

Location Address1819 CAREW STFort Wayne, IN 46805-4705

Mailing Address205 Tower DrMonroe, IN 46772-9362 · (260) 692-6163 · Fax (260) 728-3949

Phone(260) 373-7770

Fax(260) 373-7775

Sole ProprietorNo

Medical School CMSIndiana University School Of MedicineGraduated 2005

Enumeration DateMarch 28, 2007

Last NPPES UpdateApril 3, 2026

NPPES CertifiedApril 3, 2026

✔ NPI 1720107824 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in IN · 01063067A

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

1819 CAREW ST, Fort Wayne, IN 46805

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Secondary Practice Location 1

Location 1205 Tower DrMonroe, IN 46772-9362 · Phone (260) 692-6163 · Fax (260) 728-3949

Other Identifiers 1

Medicaid200970670IN

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 and accepts Medicare assignment

Dr. Nicholas Lee Nussbaum M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID9830262070

PECOS Enrollment IDI20080721000535

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 46805 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.

Referred Medical Equipment & Supplies CMS DME claims 11

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253

DME-Other DME · category DE017N

9 suppliers49 claims142 services$6.19 avg. paid by Medicare

Lancets, per box of 100 A4259

DME-Medical/Surgical Supplies · category DA000N

6 suppliers18 claims19 services$1.07 avg. paid by Medicare

Tubing with integrated heating element for use with positive airway pressure device A4604

DME-Other DME · category DE001N

5 suppliers19 claims19 services$43.02 avg. paid by Medicare

Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap A7034

DME-Other DME · category DE001N

4 suppliers17 claims17 services$73.61 avg. paid by Medicare

Headgear used with positive airway pressure device A7035

DME-Other DME · category DE001N

5 suppliers22 claims22 services$24.81 avg. paid by Medicare

Filter, disposable, used with positive airway pressure device A7038

DME-Other DME · category DE001N

5 suppliers27 claims150 services$2.61 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 14

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

MR. BRETT ALEXANDER TALLEY PA-S

Student in an Organized Health Care Education/Training Program