Northeast Indiana Ambulatory Surgery Center LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

NORTHEAST INDIANA AMBULATORY SURGERY CENTER LLC

Practice address

11277 Twin Creeks Dr.
Fort Wayne, IN 46845-2205

Phone

(260) 422-3937

NPI assigned

Sep 16, 2022

Last updated

Aug 25, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Barbara Schroeder, MDNPI 1154329100

Title

Partner

Phone

(260) 422-3937

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

Listed as

Northeast Indiana Ambulatory Surgery Center LLCCCN 15C0002013

Medicare certification status

ActiveFrom the Provider of Services file

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 2

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.

• Barbara Schroeder, M.D.

  • Ophthalmology Physician
  • Fort Wayne, IN
  • NPI 1154329100
  NPD Authorized official
• Kiersten Hopkins, OD

  • Optometrist
  • Indianapolis, IN
  • NPI 1083346910
  NPD (past)

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

{
    "created_epoch": "1663286400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692921600000",
    "number": "1437871373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11277 TWIN CREEKS DR.",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468452205",
            "telephone_number": "260-422-3937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11277 TWIN CREEKS DR.",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468452205",
            "telephone_number": "260-422-3937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHEAST INDIANA AMBULATORY SURGERY CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-16",
        "last_updated": "2023-08-25",
        "certification_date": "2023-08-25",
        "status": "A",
        "authorized_official_last_name": "SCHROEDER",
        "authorized_official_first_name": "BARBARA",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "260-422-3937",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Northeast Indiana Genetics, LLC
• Northeast Indiana Orthodontics, LLC

• Ambulatory Surgical Clinic/Center in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Ambulatory Surgical Clinic/Center in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.