Great Lakes Pediatric Surgeons, Inc.
NPI 1669455267ActiveOrganization· Surgery, Pediatric Surgery· Fort Wayne, IN
Surgery, Pediatric Surgery in Fort Wayne, Indiana, registered in NPPES in November 2005. The authorized official on file is David A. Smith, M.D., President. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1669455267 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Nov 29, 2005 |
| Last updated in NPPES | Mar 14, 2008 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Surgery, Pediatric Surgery Primary | 2086S0120X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (IN) |
|---|
Other Surgery, Pediatric Surgery providers in Fort Wayne
- 1962405993
- 1417215922
- 1679891097
- 1528024783
- 1588664932