NPIMap

Organization Active NPI

Orthopaedics Northeast, PC

Doing business as Surgery ONE

  • Ambulatory Surgical Clinic/Center
  • Fort Wayne, IN
National Provider Identifier
1154380749
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
License
50001907A Issued in IN
Legal business name
ORTHOPAEDICS NORTHEAST, PC
Doing business as
Surgery ONE
Practice address
7232 Engle Rd
Fort Wayne, IN 46804-2222
Phone
(260) 484-8551
Fax
(260) 484-9603
NPI assigned
Mar 22, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Raymond Kusisto
Title
Ceo
Phone
(260) 484-8551

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X 50001907A IN Primary

Addresses

Primary practice location

7232 Engle Rd
Fort Wayne, IN 46804-2222

Mailing address

5050 N Clinton St
Fort Wayne, IN 46825-5822
Phone (260) 484-8551

Other names 1

  • Surgery ONE Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Surgery One13 organizations share this tax ID, including this one

Other organizations with this tax ID 12

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

NPI Registry JSON

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

{
    "created_epoch": "1142985600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1154380749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5050 N CLINTON ST",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468255822",
            "telephone_number": "260-484-8551",
            "fax_number": "260-484-9603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7232 ENGLE RD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468042222",
            "telephone_number": "260-484-8551",
            "fax_number": "260-484-9603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORTHOPAEDICS NORTHEAST, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-22",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KUSISTO",
        "authorized_official_first_name": "RAYMOND",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "260-484-8551"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "IN",
            "license": "50001907A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Surgery ONE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fort Wayne, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.