NPIMap

Organization Active NPI

Southeastern Indiana Anesthesia Associates PC

  • Anesthesiology Physician
  • Columbus, IN
National Provider Identifier
1073531844
Registry record updated Apr 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
50003132A Issued in IN
Legal business name
SOUTHEASTERN INDIANA ANESTHESIA ASSOCIATES PC
Practice address
3200 Sycamore CT Ste 1B
Columbus, IN 47203-1545
Phone
(812) 378-9027
Fax
(812) 378-1014
NPI assigned
Jul 18, 2006
Last updated
Apr 2, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2024

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

Authorized official

Name
Kristy Martin
Title
Office Manager
Phone
(812) 378-9027

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 50003132A IN Primary

Addresses

Primary practice location

3200 Sycamore CT Ste 1B
Columbus, IN 47203-1545

Mailing address

3200 Sycamore CT Ste B
Columbus, IN 47203-1550
Phone (812) 378-9027

Other identifiers 1

IdentifierTypeStateIssuer
100052710MedicaidIN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050525001250 IN Part B Supplier - Clinic/Group Practice 7618919036 Receives reassigned benefits from 25 practitioners
Practice locations: Columbus, IN

National Provider Directory

National Provider Directory

Locations

1015 3rd St
Columbus, IN 47201
Phone (812) 378-9027

3200 Sycamore Ct
Ste B
Columbus, IN 47203

Practitioners & affiliated clinicians

Practitioners 30

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 30

NPI Registry JSON

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712016000000",
    "number": "1073531844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3200 SYCAMORE CT STE B",
            "city": "COLUMBUS",
            "state": "IN",
            "postal_code": "472031550",
            "telephone_number": "812-378-9027",
            "fax_number": "812-378-1014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 SYCAMORE CT STE 1B",
            "city": "COLUMBUS",
            "state": "IN",
            "postal_code": "472031545",
            "telephone_number": "812-378-9027",
            "fax_number": "812-378-1014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEASTERN INDIANA ANESTHESIA ASSOCIATES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-18",
        "last_updated": "2024-04-02",
        "certification_date": "2024-04-02",
        "status": "A",
        "authorized_official_last_name": "MARTIN",
        "authorized_official_first_name": "KRISTY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "812-378-9027"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IN",
            "license": "50003132A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100052710",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2024; 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.