Central Indiana Orthopedic Surgery Center, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

CENTRAL INDIANA ORTHOPEDIC SURGERY CENTER, LLC

Practice address

3600 W Bethel Ave
Muncie, IN 47304-5407

Phone

(765) 284-7738

Fax

(765) 213-3713

NPI assigned

Aug 9, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Victor P Moran

Title

Executive Director/Cfo

Phone

(765) 284-7738

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

Listed as

Central Indiana Orthopedic Surgery Center LLCCCN 15C0001081

Medicare certification status

ActiveFrom the Provider of Services file

Tax ID family

Central Indiana Orthopedic Surgery Center LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Central Indiana Orthopedic Surgery Center, LLC

  • Ambulatory Surgical Clinic/Center
  • Muncie, IN
  • NPI 1164917050
  NPD tax ID

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

• Fishers Specialty Surgery Center, LLC

  • Ambulatory Surgical Clinic/Center
  • Fishers, IN
  • NPI 1861059818

  Member Of

  NPD member

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Central Indiana Orthopedic Surgery Center, LLC

  • Ambulatory Surgical Clinic/Center
  • Muncie, IN
  • NPI 1164917050
  NPPES parent name

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

{
    "created_epoch": "1155081600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1429228800000",
    "number": "1447260575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1987",
            "city": "MUNCIE",
            "state": "IN",
            "postal_code": "473081987",
            "telephone_number": "765-284-7738",
            "fax_number": "765-213-3713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3600 W BETHEL AVE",
            "city": "MUNCIE",
            "state": "IN",
            "postal_code": "473045407",
            "telephone_number": "765-284-7738",
            "fax_number": "765-213-3713"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL INDIANA ORTHOPEDIC SURGERY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-09",
        "last_updated": "2015-04-17",
        "status": "A",
        "authorized_official_last_name": "MORAN",
        "authorized_official_first_name": "VICTOR",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR/CFO",
        "authorized_official_telephone_number": "765-284-7738",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM PIN",
            "identifier": "000000098210",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200220380",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Central Indiana Orthopedic Surgery Center, LLC
• Central Indiana Orthopedics LLC
• Central Indiana Orthopedics, LLC
• Central Indiana Physical Medicine & Rehab
• Central Indiana-Amg Specialty Hospital, LLC
• Central Indiana-Amg Specialty Hospital, LLC

• Ambulatory Surgical Clinic/Center in Muncie, IN
• Providers in Muncie, 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 Apr 17, 2015; 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.