Crisostomo J Carlos, MD

Primary specialty

Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X

License

01026571A Issued in IN

Practice address

801 Macarthur Blvd
Suite 305
Munster, IN 46321-2915

Phone

(219) 703-2401

Fax

(219) 703-6687

NPI assigned

Jul 13, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Cardiovascular Surgery WTWK

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Munster, IN
  • NPI 1912913526
  NPD (past)

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

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484006400000",
    "number": "1790700573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 MACARTHUR BLVD",
            "address_2": "SUITE 305",
            "city": "MUNSTER",
            "state": "IN",
            "postal_code": "463212915",
            "telephone_number": "219-703-2401",
            "fax_number": "219-703-6687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 MACARTHUR BLVD",
            "address_2": "SUITE 305",
            "city": "MUNSTER",
            "state": "IN",
            "postal_code": "463212915",
            "telephone_number": "219-703-2401",
            "fax_number": "219-703-6687"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARLOS",
        "first_name": "CRISOSTOMO",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-13",
        "last_updated": "2017-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "IN",
            "license": "01026571A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100349730",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cardiology Associates of NW Indiana, PC
• Cardiospecialists Group LTD
• Cardiovascular Consultants PC
• Cardiovascular Surgery WTWK
• Jordyn Caridinedix
• Ilona Marie Carlos, MD
• Kathleen A Carlson, NURSE PRACTITIONER
• Katie Carlson, PA-C
• Catherine Carpenter, ED.D
• Brittany Marie Carr, PA-C

• Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician in Munster, IN
• Providers in Munster, IN by specialty
• Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.