Individual provider Active NPI

Anthony Dzigbordi

  • Certified Registered Nurse Anesthetist
  • Fort Wayne, IN
National Provider Identifier
1003517954
Registry record updated Mar 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
28233741A Issued in IN
Practice address
5050 N Clinton St
Fort Wayne, IN 46825-5886
Phone
(260) 484-8551
NPI assigned
Mar 16, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 28233741A IN Primary

Addresses

Primary practice location

5050 N Clinton St
Fort Wayne, IN 46825-5886

Mailing address

5052 N Clinton St
Fort Wayne, IN 46825-5822

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230615002113 IN Practitioner - Certified Registered Nurse Anesthetist (Crna) 9739547282 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sda Consultants PLLCGroup PAC ID 3870825912, 76 clinicians
Surgery One Anesthesia LLCGroup PAC ID 8820351463, 32 clinicians

Practice addresses (Care Compare)

500 Arcade Ave
Suite 100
Elkhart, IN 46514-2478
Phone (574) 522-9505

5050 N Clinton St
Fort Wayne, IN 46825-5886
Phone (260) 484-8551

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
28233741AINMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Sda Consultants PLLC Nurse Anesthetist, Certified Registered CurrentSince Oct 1, 2024 Accepting new patients
Surgery One Anesthesia, LLC CurrentSince Jul 3, 2023 Accepting new patients

Locations

500 Arcade Ave
Ste 100
Elkhart, IN 46514
Phone (574) 389-5683

5052 N Clinton St
Fort Wayne, IN 46825
Phone (260) 408-2203

5050 N Clinton St
Fort Wayne, IN 46825
Phone (219) 484-8551

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1678924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678924800000",
    "number": "1003517954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5052 N CLINTON ST",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468255822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5050 N CLINTON ST",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468255886",
            "telephone_number": "260-484-8551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DZIGBORDI",
        "first_name": "ANTHONY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-03-16",
        "last_updated": "2023-03-16",
        "certification_date": "2023-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IN",
            "license": "28233741A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.