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THREE RIVERS DERMATOLOGY
NPI 1992991475
Specialist in Fort Wayne, IN

Active since September 19, 2007CLIA 15D1001693 · Microscopy
5650 COVENTRY LN, FORT WAYNE, IN 46804(260) 436-9696(260) 436-9424 Get Directions Write a Review

NPPES record last updated: June 12, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Three Rivers Dermatology NPPES

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

THREE RIVERS DERMATOLOGY (NPI 1992991475) is a healthcare organization registered as a specialist in Fort Wayne, Indiana and active in the NPI registry since September 2007. The organization holds a CLIA Microscopy certificate valid through July 17, 2028 and lists Jeffrey Walter Sassmannshausen, Ceo/owner, as its authorized official.

NPPES Registry Identity

NPI1992991475
Entity TypeOrganization
Primary Taxonomy174400000X
Legal Business NameTHREE RIVERS DERMATOLOGY, LLC
Location Address5650 COVENTRY LNFort Wayne, IN 46804-7140
Mailing Address5650 Coventry LnFort Wayne, IN 46804-7140 · (260) 436-9696 · Fax (260) 436-9424
Phone(260) 436-9696
Fax(260) 436-9424
Organization SubpartNo
Authorized OfficialJeffrey Walter SassmannshausenCeo/owner · (260) 436-9696
Enumeration DateSeptember 19, 2007
Last NPPES UpdateJune 12, 2020
NPPES CertifiedJune 12, 2020
✔ NPI 1992991475 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers
Taxonomy Code174400000X
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.
5650 COVENTRY LN, Fort Wayne, IN 46804
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Other Names 1

Doing Business AsThree Rivers Dermatology

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 and more.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 15D1001693

Three Rivers Dermatology · Fort Wayne, IN
Active · expires Jul 17, 2028
CLIA Number15D1001693
Laboratory TypePhysician Office
Certificate Effective DateJuly 18, 2026
Certificate Expiration DateJuly 17, 2028
Laboratory DirectorDr. Jeffrey W. Sassmannshausen
Laboratory Phone(260) 436-9696
Laboratory LocationThree Rivers Dermatology5650 Coventry Ln, Fort Wayne, IN 46804
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

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.

MISS JENIFER KAY FORTNEY PA-C
Physician Assistant (Medical)
5650 COVENTRY LN
FORT WAYNE, IN 46804
Allen County (217) 508-8478
DR. JEFFREY WALTER SASSMANNSHAUSEN M.D.
Specialist
5650 COVENTRY LN
FORT WAYNE, IN 46804
Allen County (260) 436-9696
MS. JACQUELYN RAY BEEMER PA-C
Physician Assistant
5650 COVENTRY LN
FORT WAYNE, IN 46804
Allen County (260) 436-9696
DANA LINGEL PA-C
Physician Assistant
5650 COVENTRY LN
FORT WAYNE, IN 46804
Allen County (260) 436-9696
A. MICHELLE FERGUSON PA-C
Physician Assistant
5650 COVENTRY LN
FORT WAYNE, IN 46804
Allen County (260) 436-9696

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 Three Rivers Dermatology, LLC's NPI number?

The NPI number for Three Rivers Dermatology, LLC is 1992991475. It was assigned to this organization in the NPPES registry on September 19, 2007. The provider is doing business as Three Rivers Dermatology.

Where is Three Rivers Dermatology, LLC located?

Three Rivers Dermatology, LLC is located at 5650 Coventry Ln, Fort Wayne, IN 46804. The listed phone number is (260) 436-9696.

What is Three Rivers Dermatology, LLC's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

Does Three Rivers Dermatology, LLC hold a CLIA laboratory certificate?

Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 15D1001693) is associated with this NPI, valid through July 17, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Three Rivers Dermatology, LLC accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian and Anthem Blue Cross and Blue Shield list Three Rivers Dermatology, LLC 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 Three Rivers Dermatology, LLC was last updated on June 12, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.