Active NPI
Andrew F Stasic, MD
- Pediatric Anesthesiology Physician
- Indianapolis, IN
National Provider Identifier
1770534331
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Anesthesiology Physician
- License
- 01040285
- Practice address
- 702 Barnhill Dr
Indianapolis, IN 46202-5128 - Phone
- (317) 274-0273
- Fax
- (317) 567-2191
- NPI assigned
- May 16, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | 01040285 | IN | |
| Pediatric Anesthesiology Physician | 207LP3000X | 01040285 | IN | Primary |
Addresses
Primary practice location
702 Barnhill Dr
Indianapolis, IN 46202-5128
Mailing address
1120 South Dr
Fesler Hall, RM 204
Indianapolis, IN 46202-5135
Phone (317) 274-0273
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100324940 | Medicaid | IN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01040285 | IN | MD | Anesthesiology Physician |
Interoperability endpoints
- astasic@direct.iuhealth.org
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147737600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1261353600000",
"number": "1770534331",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1120 SOUTH DR",
"address_2": "FESLER HALL, RM 204",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462025135",
"telephone_number": "317-274-0273",
"fax_number": "317-567-2191"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "702 BARNHILL DR",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462025128",
"telephone_number": "317-274-0273",
"fax_number": "317-567-2191"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STASIC",
"first_name": "ANDREW",
"middle_name": "F",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-16",
"last_updated": "2009-12-21",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "IN",
"license": "01040285",
"primary": false
},
{
"code": "207LP3000X",
"taxonomy_group": "",
"desc": "Anesthesiology, Pediatric Anesthesiology",
"state": "IN",
"license": "01040285",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100324940",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Indianapolis, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.