Organization Active NPI

Heart Care LLC

  • Internal Medicine Physician
  • Fort Wayne, IN
National Provider Identifier
1780919886
Registry record updated Jan 4, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
HEART CARE LLC
Practice address
7806 W Jefferson Blvd
Suite D
Fort Wayne, IN 46804-4180
Phone
(260) 432-7000
Fax
(260) 969-9119
NPI assigned
Oct 7, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2012

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

Authorized official

Name
Subhash K. Reddy, MDNPI 1821068511
Title
Owner
Phone
(260) 432-7000

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary
Cardiovascular Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RC0000X

Addresses

Primary practice location

7806 W Jefferson Blvd
Suite D
Fort Wayne, IN 46804-4180

Mailing address

7806 W Jefferson Blvd
Suite D
Fort Wayne, IN 46804-4180
Phone (260) 432-7000

Other identifiers 2

IdentifierTypeStateIssuer
200975120AMedicaidIN
200975120BMedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20091029000098 IN Part B Supplier - Clinic/Group Practice 0941347629 Receives reassigned benefits from 1 practitioner
Practice locations: Fort Wayne, IN

National Provider Directory

National Provider Directory

Locations

7806 W Jefferson Blvd
Ste B
Fort Wayne, IN 46804
Phone (260) 432-7000

7806 W Jefferson Blvd
Ste D
Fort Wayne, IN 46804
Phone (260) 432-7000

1250 S Washington St
Van Wert, OH 45891
Phone (419) 232-2077

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1254873600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1325635200000",
    "number": "1780919886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7806 W JEFFERSON BLVD",
            "address_2": "SUITE D",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468044180",
            "telephone_number": "260-432-7000",
            "fax_number": "260-969-9119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7806 W JEFFERSON BLVD",
            "address_2": "SUITE D",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468044180",
            "telephone_number": "260-432-7000",
            "fax_number": "260-969-9119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEART CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-07",
        "last_updated": "2012-01-04",
        "status": "A",
        "authorized_official_last_name": "REDDY",
        "authorized_official_first_name": "SUBHASH",
        "authorized_official_middle_name": "K.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "260-432-7000",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200975120A",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200975120B",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2012; 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.