SUN JIANG GUO M.D.
NPI 1942211362
Specialist in Fort Wayne, IN

Q: What is the provider's specialty?

The provider's specialty is Specialist with taxonomy code 174400000X.

Active since August 10, 2006PECOS Enrolled

2121 LAKE AVE, FORT WAYNE, IN 46805(260) 426-5431 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: July 19, 2026.

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About Sun Jiang Guo M.d. NPPES

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

SUN JIANG GUO M.D. (NPI 1942211362) is an individual specialist in Fort Wayne, Indiana, licensed in Indiana (01029090A) and active in the NPI registry since August 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1942211362

Entity TypeIndividualMale

Primary Taxonomy174400000X

Provider Legal NameSUN JIANG GUOCredential: M.D.

Location Address2121 LAKE AVEFort Wayne, IN 46805-5100

Mailing Address8916 Laurel HurstFort Wayne, IN 46835-8866 · (260) 485-9718

Phone(260) 426-5431

Sole ProprietorNo

Enumeration DateAugust 10, 2006

Last NPPES UpdateJuly 8, 2007

✔ NPI 1942211362 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers

Taxonomy Code174400000X

License✔ Licensed in IN · 01029090A

Definition

An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

2121 LAKE AVE, Fort Wayne, IN 46805

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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Sun Jiang Guo M.d. 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.