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Organization Active NPI

Central Indiana Orthopedics, LLC

  • Orthopaedic Surgery Physician
  • Anderson, IN
National Provider Identifier
1578678751
Registry record updated Feb 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
Legal business name
CENTRAL INDIANA ORTHOPEDICS, LLC
Practice address
2610 Enterprise Dr
Anderson, IN 46013-9684
Phone
(765) 683-4400
Fax
(765) 213-3713
NPI assigned
Aug 20, 2006
Last updated
Feb 6, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2023

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

Authorized official

Name
Mr. Victor P Moran
Title
Exexutive Director/Cfo
Phone
(765) 284-7738

Specialties & licenses 10

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Family Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207QS0010X
Sports Medicine (Internal Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RS0010X
Neurological Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207T00000X
Orthopaedic Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207X00000X Primary
Orthopaedic Hand Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207XS0106X
Adult Reconstructive Orthopaedic Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207XS0114X
Orthopaedic Surgery of the Spine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207XS0117X
Orthopaedic Foot and Ankle Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207XX0004X
Sports Medicine (Orthopaedic Surgery) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207XX0005X
Physical Medicine & Rehabilitation PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208100000X

Addresses

Primary practice location

2610 Enterprise Dr
Anderson, IN 46013-9684

Mailing address

PO Box 1643
Muncie, IN 47308-1643
Phone (765) 284-7738

Other identifiers 2

IdentifierTypeStateIssuer
100106820MedicaidIN
000000102884OtherINANTHEM PIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040325000156 IN Part B Supplier - Clinic/Group Practice 5698667822 Receives reassigned benefits from 162 practitioners
10 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Indianapolis, IN; Zionsville, IN; Terre Haute, IN; South Bend, IN; Plymouth, IN; Muncie, IN; Mishawaka, IN; Marion, IN…
O20100930052147 IN DME Supplier - Physician - Orthopedic/Orthopedic SurgeryDME Supplier - Physician - Internal MedicineDME Supplier - Sports Medicine 5698667822 Practice locations: Anderson, IN

Other NPIs with the same Medicare PAC ID 10

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 9

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Central Indiana Orthope14 organizations share this tax ID, including this one

Other organizations with this tax ID 13

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

View all 13

Practitioners & affiliated clinicians

Practitioners 16

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.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1156032000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675641600000",
    "number": "1578678751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1643",
            "city": "MUNCIE",
            "state": "IN",
            "postal_code": "473081643",
            "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": "2610 ENTERPRISE DR",
            "city": "ANDERSON",
            "state": "IN",
            "postal_code": "460139684",
            "telephone_number": "765-683-4400",
            "fax_number": "765-213-3713"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL INDIANA ORTHOPEDICS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-20",
        "last_updated": "2023-02-06",
        "certification_date": "2023-02-06",
        "status": "A",
        "authorized_official_last_name": "MORAN",
        "authorized_official_first_name": "VICTOR",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "EXEXUTIVE DIRECTOR/CFO",
        "authorized_official_telephone_number": "765-284-7738",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Sports Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RS0010X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Sports Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Neurological Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207XS0106X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery, Hand Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207XS0114X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207XS0117X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207XX0004X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery, Foot and Ankle Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207XX0005X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100106820",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM PIN",
            "identifier": "000000102884",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Anderson, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.