ST JOSEPH MEDICAL GROUP INC – General Practice Physician, NPI 1811952070
General Practice Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for ST JOSEPH MEDICAL GROUP INC
2622, Lake Avenue, Fort Wayne, Allen County, Indiana, 46805, United States
FORT WAYNE, IN 468055410
Phone: (260) 425-3100
Mailing address matches the actual address.
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
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Medicare Enrollment & Revalidation
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Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2004-05-25
PECOS data refreshed: 2026-05-27
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Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 46805)
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