ENT REALTY CORP NPI 1588640353

NPI Information

  • NPI: 1588640353
  • Provider Name: ENT REALTY CORP
  • Classification: Clinic/Center - 261QA1903X
  • Specialization: Ambulatory Surgical
  • Entity Type: Organization
  • Doing Business As: THE SURGERY CENTER
  • Address: 7900 W JEFFERSON BLVD
    SUITE 102
    FORT WAYNE, IN
    ZIP 46804
  • Phone: (260) 432-4368

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NPI Details

ENT REALTY CORP is an ambulatory surgical clinic center in Fort Wayne, IN. ENT REALTY CORP NPI is 1588640353. The provider is registered as an organization entity type.
The provider Is Doing Business As The Surgery Center.

The provider's business location address is:

7900 W JEFFERSON BLVD
SUITE 102
FORT WAYNE, IN
ZIP 46804-128
Phone: (260) 432-4368
Fax: (260) 436-6283

The provider's authorized official is Holly Thompson .
The authorized official title is Ceo and has the following contact phone number (260) 207-1675.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Reshaping of nasal cartilage (HCPCS:30520)
  • Evaluation of sleep-disordered breathing by examination of upper airway using an endoscope (HCPCS:42975)
  • Incision of nasal sinus using an endoscope (HCPCS:31256)
  • Removal of nasal air passage under lining tissue (HCPCS:30140)
  • Removal of nasal sinus tissue using an endoscope (HCPCS:31267)
  • Incision of eardrum with placement of eardrum tube under general anesthesia (HCPCS:69436)
  • Destruction of surface soft tissue of nasal passages (HCPCS:30802)
  • Exploration of nasal sinus using an endoscope (HCPCS:31276)
  • Removal of nasal breathing passages using an endoscope (HCPCS:31240)
  • Partial removal of nasal sinus using an endoscope (HCPCS:31254)

The enumeration date for this NPI number is 12/22/2005 and was last updated on 11/18/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QA1903XClinic/CenterAmbulatory SurgicalYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1200138850MEDICAIDINDIANA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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