Active NPI
Southern Indiana Surgery Inc
- Vascular Surgery Physician
- Columbus, IN
National Provider Identifier
1942314554
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Vascular Surgery Physician
- Legal business name
- SOUTHERN INDIANA SURGERY INC
- Practice address
- 2109 Doctors Park Dr
Columbus, IN 47203-2224 - Phone
- (812) 372-2245
- NPI assigned
- Aug 19, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Michael Dorenbusch, MD
- Title
- MD
- Phone
- (812) 372-2245
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | |||
| Vascular Surgery Physician | 2086S0129X | Primary |
Addresses
Primary practice location
2109 Doctors Park Dr
Columbus, IN 47203-2224
Mailing address
2109 Doctors Park Dr
Columbus, IN 47203-2224
Phone (812) 372-2245
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | jason.christie@sisurgery.directbygreenway.com | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IN
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20050124000908 | IN | Part B Supplier - Clinic/Group Practice | 0840240263 |
Receives reassigned benefits from 13 practitioners Practice locations: Columbus, IN |
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 15D0874105 | Vascular Center of Southern Indiana Surgery, the | Certificate of waiver | Aug 3, 2027 |
National Provider Directory
National Provider DirectoryLocations
2109 Doctors Park Dr
Columbus, IN 47203
Phone (812) 348-4080
Interoperability endpoints
- https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.70317
Practitioners & affiliated clinicians
Practitioners 13
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": "1155945600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1684800000000",
"number": "1942314554",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2109 DOCTORS PARK DR",
"city": "COLUMBUS",
"state": "IN",
"postal_code": "472032224",
"telephone_number": "812-372-2245"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2109 DOCTORS PARK DR",
"city": "COLUMBUS",
"state": "IN",
"postal_code": "472032224",
"telephone_number": "812-372-2245"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SOUTHERN INDIANA SURGERY INC",
"organizational_subpart": "NO",
"enumeration_date": "2006-08-19",
"last_updated": "2023-05-23",
"certification_date": "2023-05-23",
"status": "A",
"authorized_official_last_name": "DORENBUSCH",
"authorized_official_first_name": "MICHAEL",
"authorized_official_title_or_position": "MD",
"authorized_official_telephone_number": "812-372-2245",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Specialist",
"state": null,
"license": null,
"primary": false
},
{
"code": "2086S0129X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Surgery, Vascular Surgery",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "jason.christie@sisurgery.directbygreenway.com",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "2109 Doctors Park Dr",
"city": "Columbus",
"state": "IN",
"country_code": "US",
"postal_code": "472032224",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Columbus, IN
- Southern Indiana ENT, LLC
- Southern Indiana Integrative Therapy Services
- Southern Indiana Nephrology and Hypertension Inc
- Southern Indiana Orthopedics
- Southern Indiana Orthopedics Inc
- Southern Indiana Urologic Clinic,LLC
- Emily Helen Spagnuolo, LCSW
- Nicholas Sparks, DNP
- Chelsea Ann Spartz, NP-C
- Jennifer Shae Speer
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.