Associated Surgeons & Physicians, LLC
Organization Active NPI Colon & Rectal Surgery Physician · Fort Wayne, IN
NPI 1740689207 · NPPES record last updated Jun 13, 2016
Key facts
- NPI
- 1740689207
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Colon & Rectal Surgery Physician 208C00000X
- Legal business name
- ASSOCIATED SURGEONS & PHYSICIANS, LLC
- Practice address
- 7910 W Jefferson Blvd
Suite 305
Fort Wayne, IN 46804-4159 - Phone
- (260) 436-0259
- Fax
- (260) 436-0784
- NPI assigned
- Aug 20, 2014
- Organization subpart
- Yes
- Parent organization (as reported)
- ASSOCIATED SURGEONS & PHYSICIANS
Authorized official
- Name
- Trish Warren
- Title
- Cfo
- Phone
- (260) 432-4400
Other NPIs on the same Medicare enrollment 3
Practitioners 2
-
Amy T Thomas, MD
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IN
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20090316000381 | IN | Part B Supplier - Clinic/Group Practice | 2668539818 |
Receives reassigned benefits from 30 practitioners 3 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Fort Wayne, IN; Warsaw, IN |
National Provider Directory
- Part of
- Associated Surgeons and
Locations
7910 W Jefferson Blvd
Ste 305
Fort Wayne, IN 46804
Phone (219) 480-5069
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Colon & Rectal Surgery Physician |
208C00000X | IN | Yes |
Addresses
Primary practice location
7910 W Jefferson Blvd
Suite 305
Fort Wayne, IN 46804-4159
Mailing address
2518 E Dupont Rd
Fort Wayne, IN 46825-1675
Phone (260) 432-4400
Other names
- Center for Colon & Rectal Care
Other providers in Fort Wayne, IN
- Assistives LLC
- Associated Anesthesiologists of Fort Wayne PC
- Associated Behavioral Health Services Inc
- Associated Family Medical Consultants PC
- Associated Imaging, Inc.
- Associated Surgeons and Physicians
- Associated Surgeons and Physicians LLC
- Associated Surgeons and Physicians, LLC
- Associated Surgeons and Physicians, LLC
- Associated Surgeons and Physicians, LLC
All providers in Fort Wayne, IN · Colon & Rectal Surgery Physician in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 13, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.