NPIMap

Organization Active NPI

Orthopaedics Northeast, PC

  • Orthopaedic Surgery Physician
  • Bluffton, IN
National Provider Identifier
1467407114
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
50001907A Issued in IN
Legal business name
ORTHOPAEDICS NORTHEAST, PC
Practice address
1169 N Main St
Suite 7
Bluffton, IN 46714-1360
Phone
(260) 846-0700
Fax
(260) 846-7019
NPI assigned
May 23, 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
Orthopaedic Surgery Physician 207X00000X 50001907A IN Primary

Addresses

Primary practice location

1169 N Main St
Suite 7
Bluffton, IN 46714-1360

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": "1148342400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1467407114",
    "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": "1169 N MAIN ST",
            "address_2": "SUITE 7",
            "city": "BLUFFTON",
            "state": "IN",
            "postal_code": "467141360",
            "telephone_number": "260-846-0700",
            "fax_number": "260-846-7019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORTHOPAEDICS NORTHEAST, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-23",
        "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": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "IN",
            "license": "50001907A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bluffton, 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.