Organization Active NPI

Cardiothoracic Surgeons of Indiana LLC

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Indianapolis, IN
National Provider Identifier
1154589554
Registry record updated Oct 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
Legal business name
CARDIOTHORACIC SURGEONS OF INDIANA LLC
Practice address
8075 N Shadeland Ave
Suite 310
Indianapolis, IN 46250-2693
Phone
(317) 621-8640
Fax
(317) 621-8644
NPI assigned
Jun 2, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2008

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

Authorized official

Name
Thomas A Malasto
Title
Ceo
Phone
(317) 621-8050

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208G00000X Primary

Addresses

Primary practice location

8075 N Shadeland Ave
Suite 310
Indianapolis, IN 46250-2693

Mailing address

8075 N Shadeland Ave
Suite 310
Indianapolis, IN 46250-2693
Phone (317) 621-8640

Other identifiers 3

IdentifierTypeStateIssuer
200910050MedicaidIN
000000569471OtherINANTHEM
9615187OtherINAETNA

National Provider Directory

National Provider Directory

Locations

8075 N Shadeland Ave
Ste 310
Indianapolis, IN 46250
Phone (317) 621-8000

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1212364800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1224460800000",
    "number": "1154589554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8075 N SHADELAND AVE",
            "address_2": "SUITE 310",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462502693",
            "telephone_number": "317-621-8640",
            "fax_number": "317-621-8644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8075 N SHADELAND AVE",
            "address_2": "SUITE 310",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462502693",
            "telephone_number": "317-621-8640",
            "fax_number": "317-621-8644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARDIOTHORACIC SURGEONS OF INDIANA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-02",
        "last_updated": "2008-10-20",
        "status": "A",
        "authorized_official_last_name": "MALASTO",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "317-621-8050"
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200910050",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000569471",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "9615187",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2008; 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.