Deaconess Specialty Physicians, Inc
Organization Active NPI Cardiovascular Disease Physician · Princeton, IN
NPI 1851895486 · NPPES record last updated Jun 16, 2026
Key facts
- NPI
- 1851895486
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Cardiovascular Disease Physician 207RC0000X
- Legal business name
- DEACONESS SPECIALTY PHYSICIANS, INC
- Practice address
- 1808 Sherman Dr
Princeton, IN 47670 - Phone
- (812) 450-7899
- Fax
- (812) 450-6029
- NPI assigned
- Mar 20, 2018
- Organization subpart
- No
Authorized official
- Name
- Cheryl A Wathen
- Title
- Secretary/Treasurer
- Phone
- (812) 450-3296
Other NPIs on the same Medicare enrollment 30
Corporate family (same tax ID) 40
Practitioners 17
-
Dominic C Cefali, MD
-
Eric L Glines, ARNP
-
Kirstin Harpenau, PA
-
Umesh C Jairath, MD
-
James Michael Neahring, M.D.
-
Robert S Starrett, M.D.
-
Hoang Simon Tran, M.D.
-
Lee S Wagmeister, M.D.
-
Venkata S Yelamanchili, M.D.
-
Sridhar Banuru, MD
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IN
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20180702001637 | IN | Part B Supplier - Clinic/Group Practice | 0244595205 |
Receives reassigned benefits from 283 practitioners 30 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Newburgh, IN; Washington, IN; Vincennes, IN; Santa Claus, IN; Princeton, IN; Linton, IN; Jasper, IN; Evansville, IN… |
National Provider Directory
- Tax ID family
- Deaconess Specialty Physicians Inc
Locations
4007 Gateway Blvd
Ste 100
Newburgh, IN 47630
Phone (812) 842-0907
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Cardiovascular Disease Physician |
207RC0000X | Yes | ||
| Clinical Cardiac Electrophysiology Physician |
207RC0001X | |||
| Interventional Cardiology Physician |
207RI0011X | |||
| Orthopaedic Surgery Physician |
207X00000X | |||
| Vascular Surgery Physician |
2086S0129X | |||
| Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician |
208G00000X | |||
| Physician Assistant |
363A00000X | |||
| Medical Physician Assistant |
363AM0700X | |||
| Surgical Physician Assistant |
363AS0400X | |||
| Nurse Practitioner |
363L00000X |
Addresses
Primary practice location
1808 Sherman Dr
Princeton, IN 47670
Mailing address
PO Box 632111
Cincinnati, OH 45263-2111
Phone (812) 450-7899
Other providers in Princeton, IN
- Deaconess Hospital, Inc
- Deaconess Hospital, Inc
- Deaconess Hospital, Inc
- Deaconess Hospital, Inc
- Deaconess Specialty Physicians, Inc
- Madison Deffendall
- Betty Dillingham
- Lauren Durchholz
- William Curtis Earnest V
- Lori Michelle Edwards
All providers in Princeton, IN · Cardiovascular Disease 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 16, 2026. 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.