THREE RIVERS DERMATOLOGY
NPI 1992991475
Specialist in Fort Wayne, IN
NPI Status: Active since September 19, 2007
Contact Information
5650 COVENTRY LN
FORT WAYNE, IN
ZIP 46804
Phone: (260) 436-9696
Fax: (260) 436-9424
- Organization
- Specialist
- Accepts Insurance
- CLIA Number: 15D1001693
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 07-17-2026
About THREE RIVERS DERMATOLOGY
This page provides the complete NPI Profile along with additional information for Three Rivers Dermatology, a provider established in Fort Wayne, Indiana operating as a Specialist. The healthcare provider is registered in the NPI registry with number 1992991475 assigned on September 2007. The practitioner's primary taxonomy code is 174400000X. The provider is registered as an organization and their NPI record was last updated 6 years ago. The organization operates as a Single Specialty Group with one or more individual practitioners, all of who practice with the same area of specialization. The provider's is doing business as Three Rivers Dermatology. The authorized official of this NPI record is Dr. Jeffrey Walter Sassmannshausen M.d. (Ceo/owner)
- NPI
- 1992991475
- Provider Legal Name
- THREE RIVERS DERMATOLOGY, LLC
- Other Organization Name
- THREE RIVERS DERMATOLOGY
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 5650 COVENTRY LN FORT WAYNE, IN 46804
- Location Phone
- (260) 436-9696
- Location Fax
- (260) 436-9424
- Mailing Address
- 5650 COVENTRY LN FORT WAYNE, IN 46804
- Mailing Phone
- (260) 436-9696
- Mailing Fax
- (260) 436-9424
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 09-19-2007
- Last Update Date
- 06-12-2020
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Specialist
- Taxonomy Code
- 174400000X
- Type
- Other Service Providers
- Taxonomy Description
- 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.
Group Taxonomy 193400000X SINGLE SPECIALTY GROUP
This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Choice Bronze HSA - HMO
- Choice Bronze HSA + Vision + Adult Dental - HMO
- Clear Gold - HMO
- Clear Gold + Vision + Adult Dental - HMO
- Complete Gold - HMO
- Complete Gold + Vision + Adult Dental - HMO
- Complete Silver - HMO
- Complete Silver + Vision + Adult Dental - HMO
- Everyday Bronze - HMO
- Everyday Bronze + Vision + Adult Dental - HMO
- Standard Expanded Bronze - HMO
- Standard Expanded Bronze + Vision + Adult Dental - HMO
- Standard Gold - HMO
- Standard Gold + Vision + Adult Dental - HMO
- Standard Silver - HMO
- Standard Silver + Vision + Adult Dental - HMO
- Clear Silver - HMO
- Elite Gold - HMO
- Elite Gold + Vision + Adult Dental - HMO
- Everyday Gold - HMO
- Everyday Gold + Vision + Adult Dental - HMO
- Standard Gold - HMO
- Standard Gold + Vision + Adult Dental - HMO
- Standard Silver - HMO
- Standard Silver + Vision + Adult Dental - HMO
- Complete Gold - HMO
- Complete Gold + Vision + Adult Dental - HMO
- Elite Gold - HMO
- Elite Gold + Vision + Adult Dental - HMO
- Focused Silver - HMO
- Focused Silver + Vision + Adult Dental - HMO
- Standard Gold - HMO
- Standard Gold + Vision + Adult Dental - HMO
- Standard Silver - HMO
- Standard Silver + Vision + Adult Dental - HMO
- Anthem Bronze Essential 10150 ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Anthem Bronze Essential 10150 Adult Dental/Vision ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Anthem Bronze Essential 6500 HSA (+ Incentives) - HMO
- Anthem Bronze Essential 7500 Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Anthem Bronze Essential POS 5500 ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
- Anthem Bronze Essential POS 7500 Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
- Anthem Catastrophic Essential (+ Incentives) - HMO
- Anthem Gold Essential 2000 Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Anthem Gold Essential 2200 ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Anthem Heart Healthy Bronze Essential 4500 ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Anthem Heart Healthy Silver Essential 4500 ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Anthem Silver Essential 3500 HSA (+ Incentives) - HMO
- Anthem Silver Essential 6000 Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Anthem Silver Essential 7000 ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Anthem Silver Essential 7000 Adult Dental/Vision ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 15D1001693
- Facility Type
- Physician Office
- Certificate Effective Date
- July 18, 2024
- Certificate Expiration Date
- July 17, 2026
- Laboratory Director
- DR. JEFFREY W. SASSMANNSHAUSEN
- Certificate Type
- Certificate for Provider-Performed Microscopy Procedures (PPMP)
- Certificate Type Description
- This CLIA certificate is issued to Three Rivers Dermatology in which a physician, midlevel practitioner or dentist that performs specific microscopy procedures during the course of a patient's visit. A limited list of provider-performed microscopy procedures is included under this certificate type, which are categorized as moderate complexity testing.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1992991475, we treat the final digit (5) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 75. The final step is to find the difference between that total and the next multiple of ten (80 - 75 = 5).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 75 is 80. The difference is the calculated check digit.
Other Providers at the Same Location
The following 5 providers are registered at the same or a nearby location.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1992991475, enumerated as an "organization" on September 19, 2007.
The provider is located at 5650 COVENTRY LN FORT WAYNE, IN 46804 and the phone number is (260) 436-9696.
Specialist with taxonomy code 174400000X.
The provider might be accepting Accepts: Ambetter from Buckeye Health Plan, Ambetter from. Please consult your insurance carrier or call the provider to verify.
