NPIMap

Organization Active NPI

University Vascular Surgery, Inc

  • Vascular Surgery Physician
  • Indianapolis, IN
National Provider Identifier
1043328487
Registry record updated Sep 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
Legal business name
UNIVERSITY VASCULAR SURGERY, INC
Practice address
1801 Senate Blvd
MPC 2, Suite D3500
Indianapolis, IN 46202-1228
Phone
(317) 962-0280
Fax
(317) 962-0289
NPI assigned
Aug 27, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2020

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

Authorized official

Name
Judith Coleman
Title
Cfo
Phone
(317) 948-3525

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2086S0129X Primary

Addresses

Primary practice location

1801 Senate Blvd
MPC 2, Suite D3500
Indianapolis, IN 46202-1228

Mailing address

250 N Shadeland Ave Ste 200
Indianapolis, IN 46219-4959
Phone (877) 668-5621

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041101000327 IN Part B Supplier - Clinic/Group Practice 7911969050 Receives reassigned benefits from 20 practitioners
Practice locations: Carmel, IN; Indianapolis, IN; Avon, IN

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

1115 Ronald Reagan Pkwy
Ste 236
Avon, IN 46123
Phone (317) 217-2700

151 Pennsylvania Pkwy
Carmel, IN 46280
Phone (317) 817-1100

1001 W 10th St
Ste S303
Indianapolis, IN 46202

250 N Shadeland Ave
#200
Indianapolis, IN 46219

1701 N Senate Ave
Ste AG59
Indianapolis, IN 46202

1001 W 10th St
#S303
Indianapolis, IN 46202
Phone (317) 630-7360

1001 W 10th St
Rm 303
Indianapolis, IN 46202

65 E 21st St
Indianapolis, IN 46202
Phone (317) 931-5222

1701 Senate Blvd
#59
Indianapolis, IN 46202

1001 W 10th St
#310
Indianapolis, IN 46202

Practitioners & affiliated clinicians

Practitioners 28

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 28

NPI Registry JSON

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

{
    "created_epoch": "1156636800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1601424000000",
    "number": "1043328487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 N SHADELAND AVE STE 200",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462194959",
            "telephone_number": "877-668-5621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 SENATE BLVD",
            "address_2": "MPC 2, SUITE D3500",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462021228",
            "telephone_number": "317-962-0280",
            "fax_number": "317-962-0289"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY VASCULAR SURGERY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-27",
        "last_updated": "2020-09-30",
        "certification_date": "2020-09-30",
        "status": "A",
        "authorized_official_last_name": "COLEMAN",
        "authorized_official_first_name": "JUDITH",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "317-948-3525"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.