THREE RIVERS DERMATOLOGY
NPI 1992991475
Specialist in Fort Wayne, IN
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
Specialties & Licenses
Other Names 1
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Three Rivers Dermatology is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Three Rivers Dermatology, which bills Medicare for the services this clinician delivers.
Clinician (1)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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, INFrequently 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.
Is Three Rivers Dermatology, LLC enrolled in Medicare?
Yes. Three Rivers Dermatology, LLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Three Rivers Dermatology, LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Dermatology) reassigns their Medicare billing to Three Rivers Dermatology, LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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.
# Three Rivers Dermatology · NPI 1992991475
Specialist organization in Fort Wayne, Indiana. Organization record, active in the CMS NPPES registry since September 19, 2007.
## Identity
- **NPI:** 1992991475 (Entity type: Organization)
- **Enumerated:** September 19, 2007
- **Primary specialty:** Specialist · taxonomy 174400000X
- **Legal business name:** Three Rivers Dermatology, Llc
- **Organization subpart:** No
- **Authorized official:** Jeffrey Sassmannshausen, CEO/OWNER
## Practice location
- **Address:** 5650 COVENTRY LN, Fort Wayne, IN 46804-7140
- **Phone:** (260) 436-9696 · **Fax:** (260) 436-9424
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Dermatology) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** June 12, 2020
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1992991475) · Data from the CMS NPPES public registry.