Cardiovascular Associates of Northeastern Indiana LLC

Primary specialty

Vascular Surgery PhysicianTaxonomy code 2086S0129X

Legal business name

CARDIOVASCULAR ASSOCIATES OF NORTHEASTERN INDIANA LLC

Practice address

7900 W Jefferson Blvd
Suite 303
Ft Wayne, IN 46804-4128

Phone

(260) 436-6098

Fax

(260) 436-3173

NPI assigned

Jan 24, 2006

Organization subpart

No

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

Authorized official

Name

John Csicsko, MD

Title

Owner

Phone

(260) 436-6098

Specialties & licenses 1

Addresses

Other identifiers 2

Practitioners 1

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

• David P Lloyd, MD

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Fort Wayne, IN
  • NPI 1003816711
  NPD (past)

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

{
    "created_epoch": "1138060800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1322438400000",
    "number": "1083684948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7900 W JEFFERSON BLVD",
            "address_2": "SUITE 303",
            "city": "FT WAYNE",
            "state": "IN",
            "postal_code": "468044128",
            "telephone_number": "260-436-6098",
            "fax_number": "260-436-3173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7900 W JEFFERSON BLVD",
            "address_2": "SUITE 303",
            "city": "FT WAYNE",
            "state": "IN",
            "postal_code": "468044128",
            "telephone_number": "260-436-6098",
            "fax_number": "260-436-3173"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARDIOVASCULAR ASSOCIATES OF NORTHEASTERN INDIANA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-24",
        "last_updated": "2011-11-28",
        "status": "A",
        "authorized_official_last_name": "CSICSKO",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "260-436-6098",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200049160A",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAVELERS MEDICARE",
            "identifier": "CA5617",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Cole Carey, RBT
• Sarah Carey

• Vascular Surgery Physician in Ft Wayne, IN
• Providers in Ft Wayne, IN by specialty
• Vascular Surgery Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.