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Northstar Anesthesia of Indiana LLC

Organization Active NPI Anesthesiology Physician · Arlington, TX

NPI 1043561541 · NPPES record last updated May 25, 2021

Key facts

NPI
1043561541
Entity type
Organization (NPI type 2)
Primary specialty
Anesthesiology Physician 207L00000X
Legal business name
NORTHSTAR ANESTHESIA OF INDIANA LLC
Practice address
2000 E Lamar Blvd
Suite 400
Arlington, TX 76006
Phone
(682) 227-6839
Fax
(682) 227-6869
NPI assigned
Sep 24, 2012
Organization subpart
No

Authorized official

Name
Philip W Eichenholz, MD NPI 1427037084
Title
MD/Ceo
Phone
(682) 227-6849

Authorized official NPPES reports the authorized official by name only; the link goes to the one practitioner connected to this organization with that name.

Corporate family (same tax ID) 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners 287

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

View all 287

Medicare participation

Medicare fee-for-service enrollment
Enrolled in IN

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20130227000297 IN Part B Supplier - Clinic/Group Practice 1153576905 Receives reassigned benefits from 276 practitioners
Practice locations: Carmel, IN; Dyer, IN; Hammond, IN; Munster, IN; New Albany, IN

National Provider Directory

Tax ID family
North Star Anesthesia of Indiana (2 organizations share this tax ID)

Locations

12750 Saint Francis Dr
Crown Point, IN 46307
Phone (219) 738-2100

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician
Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP		 207L00000X Yes
Certified Registered Nurse Anesthetist
Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP		 367500000X

Addresses

Primary practice location

2000 E Lamar Blvd
Suite 400
Arlington, TX 76006

Mailing address

PO Box 612364
Dallas, TX 75261-2364
Phone (239) 610-0775

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on May 25, 2021.

{
    "created_epoch": "1348444800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1621900800000",
    "number": "1043561541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 612364",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752612364",
            "telephone_number": "239-610-0775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 E LAMAR BLVD",
            "address_2": "SUITE 400",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "76006",
            "telephone_number": "682-227-6839",
            "fax_number": "682-227-6869"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHSTAR ANESTHESIA OF INDIANA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-24",
        "last_updated": "2021-05-25",
        "certification_date": "2021-05-25",
        "status": "A",
        "authorized_official_last_name": "EICHENHOLZ",
        "authorized_official_first_name": "PHILIP",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "MD/CEO",
        "authorized_official_telephone_number": "682-227-6849",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "367500000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arlington, TX

All providers in Arlington, TX · Anesthesiology Physician in Texas

Sources for this page

Verify at the official NPI Registry.