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CARDIOVASCULAR ASSOCIATES OF NORTHEASTERN INDIANA LLC NPI 1083684948


NPI Information

NPI: 1083684948
Provider Name: CARDIOVASCULAR ASSOCIATES OF NORTHEASTERN INDIANA LLC
Classification: Surgery - 2086S0129X
Entity Type: Organization

Specialization: Vascular Surgery

Address:
7900 W JEFFERSON BLVD
SUITE 303
FT WAYNE, IN
ZIP 46804
Phone: (260) 436-6098
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CARDIOVASCULAR ASSOCIATES OF NORTHEASTERN INDIANA LLC is a vascular surgery surgery in Ft Wayne, IN. The provider is a surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. CARDIOVASCULAR ASSOCIATES OF NORTHEASTERN INDIANA LLC NPI is 1083684948. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

7900 W JEFFERSON BLVD
SUITE 303
FT WAYNE, IN
ZIP 46804-128
Phone: (260) 436-6098
Fax: (260) 436-3173

The provider's authorized official is John Csicsko .
The authorized official title is Owner and has the following contact phone number (260) 436-6098.

The enumeration date for this NPI number is 1/24/2006 and was last updated on 11/28/2011.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
12086S0129XSurgeryVascular SurgeryYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1CA5617OTHERINDIANATAVELERS MEDICARE
2200049160AMEDICAIDINDIANA
3667590MEDICARE PININDIANA
46370370001MEDICARE NSCINDIANA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024
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