Individual ProviderSara M RothgebNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address10228 Dupont Circle Dr E Ste 100, Fort Wayne, IN 46825-1611(260) 222-7401(317) 575-7304PECOS EnrollmentBased on the most recent information from CMS, provider Sara M Rothgeb does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 3 days ago.Profile DetailsProvider ID1033763420Provider TypeIndividualFull NameRothgeb, Sara MTitleMrs.CredentialMSN, FNP-CGenderFemaleSole ProprietorNoEnumeration Date7/24/2019Last Updated2/1/2023Contact InformationPractice LocationPractice Address10228 Dupont Circle Dr E Ste 100, Fort Wayne, IN 46825-1611Phone(260) 222-7401Fax(260) 209-5956Mailing LocationMailing AddressPO Box 772437, Detroit, MI 48277-2437Phone(317) 575-7304Fax(317) 575-7333Provider TaxonomiesCodeDescriptionLicenseCode363L00000XPrimaryDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicense71009308AIndianaCode363L00000XDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicense28214366AIndiana