Great Lakes Pediatric Surgeons, Inc.
NPI 1669455267 · Pediatric Surgery Physician · Fort Wayne, IN
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Great Lakes Pediatric Surgeons, Inc. is a Pediatric Surgery Physician organization in Fort Wayne, IN (NPI 1669455267).
Provider details
- NPI number
- 1669455267
- Entity type
- Organization
- Primary specialty
- Pediatric Surgery PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- David Smith, President(260) 469-7337
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
20 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2005-11-29
- Last updated
- 2008-03-14
Frequently asked questions
- What is Great Lakes Pediatric Surgeons, Inc.'s NPI number?
- Great Lakes Pediatric Surgeons, Inc.'s National Provider Identifier (NPI) is 1669455267, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Great Lakes Pediatric Surgeons, Inc.?
- Great Lakes Pediatric Surgeons, Inc. is classified in the NPPES registry as Pediatric Surgery Physician (Allopathic & Osteopathic Physicians).
- Where is Great Lakes Pediatric Surgeons, Inc. located?
- Great Lakes Pediatric Surgeons, Inc.'s practice location on file with NPPES is 7613 W Jefferson Blvd Ste 200, Fort Wayne, IN 46804-4182.
- What is Great Lakes Pediatric Surgeons, Inc.'s phone number?
- The practice phone number listed in the NPPES registry for Great Lakes Pediatric Surgeons, Inc. is (260) 469-7337.
- Does Great Lakes Pediatric Surgeons, Inc. accept Medicare?
- Great Lakes Pediatric Surgeons, Inc. is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Great Lakes Pediatric Surgeons, Inc.?
- The authorized official listed on Great Lakes Pediatric Surgeons, Inc.'s NPPES record is David Smith, President. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Great Lakes Pediatric Surgeons, Inc.'s NPI active?
- Yes — Great Lakes Pediatric Surgeons, Inc.'s NPI (1669455267) is active in the NPPES registry as of the last update on 2008-03-14.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.