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 5 years ago. The organization operates as a single speciality business group with one or more individual providers who practice 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:
- Clear Silver - HMO
- Elite Bronze - HMO
- Elite Bronze + Vision + Adult Dental - HMO
- Elite Gold - HMO
- Elite Gold + Vision + Adult Dental - HMO
- Everyday Bronze - HMO
- Everyday Bronze + Vision + Adult Dental - HMO
- Everyday Gold - HMO
- Everyday Gold + Vision + Adult Dental - HMO
- Focused Silver - HMO
- Focused Silver + 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
- Choice Bronze HSA - HMO
- Choice Bronze HSA + Vision + Adult Dental - HMO
- Clear Gold - HMO
- Clear Gold + Vision + Adult Dental - HMO
- Clear Silver - HMO
- Complete Gold - HMO
- Complete Gold + Vision + Adult Dental - HMO
- Complete Silver - HMO
- Complete Silver + Vision + Adult Dental - HMO
- Elite Gold - HMO
- Elite Gold + Vision + Adult Dental - HMO
- Everyday Bronze - HMO
- Everyday Bronze + Vision + Adult Dental - HMO
- Focused Silver - HMO
- Focused Silver + 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
- Central Bronze - HMO
- Central Bronze + Vision + Adult Dental - HMO
- Central Gold - HMO
- Central Gold + Vision + Adult Dental - HMO
- Clear Silver - HMO
- Everyday Bronze - HMO
- Everyday Bronze + Vision + Adult Dental - HMO
- Everyday Gold - HMO
- Everyday Gold + Vision + Adult Dental - HMO
- Focused Silver - HMO
- Focused Silver + 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
*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.
Reviews for THREE RIVERS DERMATOLOGY
There are currently no reviews for this provider. Be the first person to share your experience with this provider by filling out our review form. Your insights are appreciated and will help others make informed decisions.
NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 9 | 9 | 2 | 9 | 9 | 1 | 4 | 7 | 5 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 9 | 18 | 2 | 18 | 9 | 2 | 4 | 14 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 9 + 1 + 8 + 2 + 1 + 8 + 9 + 2 + 4 + 1 + 4 + 24 = 75 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 80 - 75 = 5 | 5 | ||||||||
The NPI number 1992991475 is valid because the calculated check digit 5 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 5 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1396248415 | MS. JACQUELYN RAY BEEMER PA-C Individual | Physician Assistant | 5650 COVENTRY LN FORT WAYNE, IN 46804 (260) 436-9696 |
| 1073963351 | MISS JENIFER KAY FORTNEY PA-C Individual | Physician Assistant (Medical) | 5650 COVENTRY LN FORT WAYNE, IN 46804 (217) 508-8478 |
| 1316928195 | DR. JEFFREY WALTER SASSMANNSHAUSEN M.D. Individual | Specialist | 5650 COVENTRY LN FORT WAYNE, IN 46804 (260) 436-9696 |
| 1750390902 | A. MICHELLE FERGUSON PA-C Individual | Physician Assistant | 5650 COVENTRY LN FORT WAYNE, IN 46804 (260) 436-9696 |
| 1740905488 | DANA LINGEL PA-C Individual | Physician Assistant | 5650 COVENTRY LN FORT WAYNE, IN 46804 (260) 436-9696 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1992991475, enumerated in the NPI registry 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
This medical organization specializes in Specialist with taxonomy code 174400000X
The provider might be accepting Accepts: Ambetter from Meridian, Ambetter Health and. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
The provider's CLIA number is 15D1001693 for a "physician office" facility with a CLIA Certificate for Provider-Performed Microscopy Procedures (PPMP). This CLIA certificate is issued 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..
This NPI record was last updated on September 19, 2007. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
NPI Profile data is regularly updated with the latest NPI registry information, if you would like to update or remove your NPI Profile in this website please contact us.