NPIMap

Organization Active NPI

Cardinal Anesthesia, LLC

  • Certified Registered Nurse Anesthetist
  • Granger, IN
National Provider Identifier
1134570153
Registry record updated Oct 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
Legal business name
CARDINAL ANESTHESIA, LLC
Practice address
51050 Bittersweet Rd
Granger, IN 46530-7879
Phone
(718) 208-0446
NPI assigned
Jun 30, 2016
Last updated
Oct 4, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2023

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

Authorized official

Name
Roni Aizigov, CRNANPI 1174876577
Title
President and Ceo
Phone
(718) 208-0446

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse AnesthetistGroup: 193400000X SINGLE SPECIALTY GROUP 367500000X Primary

Addresses

Primary practice location

51050 Bittersweet Rd
Granger, IN 46530-7879

Mailing address

51050 Bittersweet Rd
Granger, IN 46530-7879

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160804000791 IN Part B Supplier - Clinic/Group Practice 2668766254 Receives reassigned benefits from 16 practitioners
Practice locations: Granger, IN

National Provider Directory

National Provider Directory

Locations

51050 Bittersweet Rd
Granger, IN 46530
Phone (718) 208-0446

Practitioners & affiliated clinicians

Practitioners 16

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 16

NPI Registry JSON

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

{
    "created_epoch": "1467244800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696377600000",
    "number": "1134570153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "51050 BITTERSWEET RD",
            "city": "GRANGER",
            "state": "IN",
            "postal_code": "465307879"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "51050 BITTERSWEET RD",
            "city": "GRANGER",
            "state": "IN",
            "postal_code": "465307879",
            "telephone_number": "718-208-0446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARDINAL ANESTHESIA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-30",
        "last_updated": "2023-10-04",
        "certification_date": "2021-04-26",
        "status": "A",
        "authorized_official_last_name": "AIZIGOV",
        "authorized_official_first_name": "RONI",
        "authorized_official_title_or_position": "PRESIDENT AND CEO",
        "authorized_official_telephone_number": "718-208-0446",
        "authorized_official_credential": "CRNA"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Granger, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2023; 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.