Indianapolis Perioperative Medicine, LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

1053181A Issued in IN

Legal business name

INDIANAPOLIS PERIOPERATIVE MEDICINE, LLC

Practice address

13000 E 136TH St
Suite 1100
Fishers, IN 46037-9478

Phone

(317) 678-3585

Fax

(317) 863-5084

NPI assigned

Jun 29, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Peter Caccavallo, M.D.NPI 1205987252

Title

Owner

Phone

(317) 678-3585

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Peter Caccavallo

  • Internal Medicine Physician
  • Fishers, IN
  • NPI 1205987252
  Medicare reassignment Care Compare group NPD Authorized official
• Abigail Williamson

  • Nurse Practitioner
  • Indianapolis, IN
  • NPI 1124534367
  Medicare reassignment Care Compare group NPD
• Kaicy Christner James, FNP-C

  • Family Nurse Practitioner
  • Greencastle, IN
  • NPI 1316609498
  Medicare reassignment NPD
• Elizabeth Mary Kent

  • Family Nurse Practitioner
  • Terre Haute, IN
  • NPI 1174240592
  Medicare reassignment NPD
• Shelby Ann Miller, PA-C

  • Physician Assistant
  • Carmel, IN
  • NPI 1316499940
  Medicare reassignment

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

{
    "created_epoch": "1183075200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1405382400000",
    "number": "1720285976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13000 E 136TH ST",
            "address_2": "SUITE 1100",
            "city": "FISHERS",
            "state": "IN",
            "postal_code": "460379478",
            "telephone_number": "317-678-3585",
            "fax_number": "317-863-5084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13000 E 136TH ST",
            "address_2": "SUITE 1100",
            "city": "FISHERS",
            "state": "IN",
            "postal_code": "460379478",
            "telephone_number": "317-678-3585",
            "fax_number": "317-863-5084"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDIANAPOLIS PERIOPERATIVE MEDICINE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-29",
        "last_updated": "2014-07-15",
        "status": "A",
        "authorized_official_last_name": "CACCAVALLO",
        "authorized_official_first_name": "PETER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "317-678-3585",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "IN",
            "license": "1053181A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200424870-A",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE GROUP",
            "identifier": "DE0272",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Indiana University Health Ambulatory Surgery Centers, LLC (Fishers Surgery Center)
• Indiana University Health Inc (IU Health Pharmacy Fishers)
• Indiana University Health Inc (Sleep Apnea Education Center at Indiana University Health Saxony)
• Indiana University Health Saxony Surgery Center LLC (Saxony Surgery Center)
• Indianapolis Perioperative Medicine
• Indianapolis TMS, LLC
• Indy Center for Sleep Health LLC
• Indy Child Therapist, LLC
• Indy Lactation Care,LLC
• Indy Nemt LLC

• Internal Medicine Physician in Fishers, IN
• Providers in Fishers, IN by specialty
• Internal Medicine Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2014; 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.