NPIMap

Organization Active NPI

Orthopaedics Northeast, PC

  • Podiatrist
  • North Manchester, IN
National Provider Identifier
1457311995
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
50001907A Issued in IN
Legal business name
ORTHOPAEDICS NORTHEAST, PC
Practice address
605 N Walnut St
North Manchester, IN 46962-1857
Phone
(260) 484-8551
Fax
(260) 484-9603
NPI assigned
Mar 27, 2006
Last updated
Sep 11, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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 4

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 50001907A IN
Orthopaedic Surgery Physician 207X00000X 50001907A IN
Physical Medicine & Rehabilitation Physician 208100000X 50001907A IN
Podiatrist 213E00000X 50001907A IN Primary

Addresses

Primary practice location

605 N Walnut St
North Manchester, IN 46962-1857

Mailing address

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

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": "1143417600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1457311995",
    "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": "605 N WALNUT ST",
            "city": "NORTH MANCHESTER",
            "state": "IN",
            "postal_code": "469621857",
            "telephone_number": "260-484-8551",
            "fax_number": "260-484-9603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORTHOPAEDICS NORTHEAST, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-27",
        "last_updated": "2025-09-11",
        "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": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IN",
            "license": "50001907A",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "IN",
            "license": "50001907A",
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "IN",
            "license": "50001907A",
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "IN",
            "license": "50001907A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Manchester, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.