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PEDIATRIC SURGICAL ASSOCIATES INC NPI 1790880292


NPI Information

NPI: 1790880292
Provider Name: PEDIATRIC SURGICAL ASSOCIATES INC
Classification: Surgery - 2086S0120X
Entity Type: Organization

Specialization: Pediatric Surgery

Address:
250 N SHADELAND AVE STE 200
INDIANAPOLIS, IN
ZIP 46219
Phone: (877) 668-5621
Get Directions

PEDIATRIC SURGICAL ASSOCIATES INC is a pediatric surgery surgery in Indianapolis, IN. The provider is a surgeon with expertise in the management of surgical conditions in premature and newborn infants, children and adolescents. PEDIATRIC SURGICAL ASSOCIATES INC NPI is 1790880292. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

250 N SHADELAND AVE STE 200
INDIANAPOLIS, IN
ZIP 46219-959
Phone: (877) 668-5621

The provider's authorized official is Judith Coleman .
The authorized official title is Cfo and has the following contact phone number (317) 948-3525.

The enumeration date for this NPI number is 9/13/2006 and was last updated on 9/30/2020.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
12086S0120XSurgeryPediatric SurgeryYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1200349840MEDICAIDINDIANA

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: 4/28/2024

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