Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Brian T Laursen, PA

Individual provider Physician Assistant · NPI 1164425187

Brian T Laursen, PA is a Physician Assistant in Fort Wayne, Indiana. Qualified in 2003, 23 years ago. Practices with Medstat LLC, an 8-clinician group and accepts Medicare assignment. Licensed in Indiana.

Years since qualifying
23
Licensed in
IN
In the registry since
2005
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

7601 W Jefferson Blvd
Fort Wayne, IN 46804-4133
Phone: (260) 436-8686
Fax: (260) 432-5075
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 10000668A (IN)

Record details

NPI number1164425187
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorNo
NPI enumeratedMay 23, 2005
Last updated in NPPESSeptember 19, 2023
Certification dateSeptember 19, 2023

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2003 (23 years in practice)
Group practice Medstat Llc — 8 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations11 on file with Medicare

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