Mrs Mary Elizabeth Fortman, NP is a medicare enrolled "Nurse Practitioner" in Ft. Wayne, Indiana. She graduated from nursing school in 2020 and has 5 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Consonant Healing Associates Of De Llc and her current practice location is
Parkview Health, 11108 Parkview Circle Dr, Door 10, Ft. Wayne, Indiana. You can reach out to her office (for appointments etc.) via phone at
(260) 266-1000.
Mrs Mary Elizabeth Fortman is licensed to practice in Indiana (license number 71010812A) and she also participates in the medicare program. She
accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1942892682.
Provider's Profile
Full Name | Mrs Mary Elizabeth Fortman |
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Gender | Female |
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Speciality | Nurse Practitioner |
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Experience | 5 Years |
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Location | Parkview Health, Ft. Wayne, Indiana |
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Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Medical Education and Training:
- Mrs Mary Elizabeth Fortman graduated from nursing school in 2020
NPI Data:
- NPI Number: 1942892682
- Provider Enumeration Date: 02/04/2021
- Last Update Date: 02/04/2021
Medicare PECOS Information:
- PECOS PAC ID: 9739577438
- Enrollment ID: I20211029001424
Medical Identifiers
Medical identifiers for Mrs Mary Elizabeth Fortman such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1942892682 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
363LF0000X | Nurse Practitioner - Family | 71010812A (Indiana) | Secondary |
363L00000X | Nurse Practitioner | 71010812A (Indiana) | Primary |
Group Practice Association
Group Practice Name | Group PECOS PAC ID | No. of Members |
Consonant Healing Associates Of De Llc | 2466871694 | 69 |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Mrs Mary Elizabeth Fortman allows following entities to bill medicare on her behalf.
Entity Name | Consonant Healing Associates Of De Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1669099321 PECOS PAC ID: 2466871694 Enrollment ID: O20210325000520 |
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Entity Name | Decatur Urgent Care Walk In Clinic Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1669131074 PECOS PAC ID: 6103210869 Enrollment ID: O20220223002835 |
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Entity Name | Auburn Urgent Care Walk In Clinic |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1518605716 PECOS PAC ID: 4688052228 Enrollment ID: O20220609002096 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mrs Mary Elizabeth Fortman is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Mrs Mary Elizabeth Fortman, NP 1828 S. Tyland Blvd., New Haven, IN 46774 Ph: (260) 615-1031 | Mrs Mary Elizabeth Fortman, NP Parkview Health, 11108 Parkview Circle Dr, Door 10, Ft. Wayne, IN 46845 Ph: (260) 266-1000 |
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