GYNECOLOGIC ONCOLOGY OF NORTHEAST INDIANA, LLC (NPI# 1295141380) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295141380 |
| Entity Type | Organization |
| Organization Name | GYNECOLOGIC ONCOLOGY OF NORTHEAST INDIANA, LLC |
| Practice Address |
1818 Carew St Suite 250 Fort Wayne IN 46805-4788 |
| Mailing Address |
Po Box 307 Roanoke IN 46783-0307 |
| Practice Telephone | 2604374789 |
| Mailing Telephone | 2604374789 |
| Enumeration Date | 2014-07-09 |
| Last Update Date | 2016-06-21 |
| Authorized Official Name | IWONA PODZIELINSKI (PRESIDENT/OWNER) |
| Authorized Official Telephone | 2604374789 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207VX0201X |
Obstetrics & Gynecology Specialization: Gynecologic Oncology |
IN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OH | 0107737 | 05 | |
| IN | 201236690 | 05 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Indiana Business Entities | GYNECOLOGIC ONCOLOGY OF NORTHEAST INDIANA, LLC | 14636 Chopine Pass, Fort Wayne, IN 46783 |
| Street Address |
1818 CAREW ST SUITE 250 |
| City | FORT WAYNE |
| State | IN |
| Zip Code | 46805-4788 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447257795 | P. Rao Gummadi | Anesthesiology | 1818 Carew St, Suite 220, Fort Wayne, IN 46805-4788 | 2005-07-01 |
| 1912393570 | Kelly Horn | Midwife | 1818 Carew St, Suite 300, Fort Wayne, IN 46805-4788 | 2015-04-10 |
| 1174802649 | Matthew L Runyan | Psychiatry & Neurology | 1818 Carew St, Suite 230, Fort Wayne, IN 46805-4788 | 2011-08-15 |
| 1861647000 | Patrick Andrew Macknick | Physician Assistant | 1818 Carew St, Suite 250, Fort Wayne, IN 46805-4788 | 2008-12-01 |
| 1013169275 | Jeri Ann Forrest | Social Worker | 1818 Carew St, Suite 230, Fort Wayne, IN 46805-4788 | 2008-10-21 |
| 1013179357 | Carol Pai Wain Garrean | Internal Medicine | 1818 Carew St, Suite 260, Fort Wayne, IN 46805-4788 | 2008-06-27 |
| 1922156512 | Robert W Miner | Psychiatry & Neurology | 1818 Carew St, Fort Wayne, IN 46805-4788 | 2007-01-08 |
| 1316011349 | Parkview Health System, Inc. | Durable Medical Equipment & Medical Supplies | 1818 Carew St, Suite 260, Fort Wayne, IN 46805-4792 | 2006-11-20 |
| 1801960596 | Parkview Health System, Inc. | Durable Medical Equipment & Medical Supplies | 1818 Carew St, Suite 240, Fort Wayne, IN 46805-4788 | 2006-11-17 |
| 1508945809 | Fort Wayne Urology Inc. | Urology | 1818 Carew St, Suite 210, Fort Wayne, IN 46805-4788 | 2006-11-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619589546 | Connor Gemlick | Student in an Organized Health Care Education/Training Program | 1918 Carew St., Fort Wayne, IN 46805 | 2020-08-21 |
| 1710464086 | S.t.a.r. Care Services | Clinic/Center | 3521 Lake Avenue, Suite #4, Fort Wayne, IN 46805 | 2018-07-19 |
| 1083122865 | Noel Shafi | Counselor | 3010 East State Boulevard, Fort Wayne, IN 46805 | 2018-01-16 |
| 1063963627 | Toni L Irby | Specialist | 3219 E State Blvd, Fort Wayne, IN 46805 | 2016-10-19 |
| 1639626211 | Logan Schwerer | Pharmacist | 923 Northcrest Business Center 6d, Fort Wayne, IN 46805 | 2016-09-01 |
| 1063817104 | Michale Diane Rothgeb | Physical Therapy Assistant | 2200 Randollia Dr, Fort Wayne, IN 46805 | 2014-10-31 |
| 1124435789 | Julia I. Mcfann | Physical Therapist | 2200 Randalia Dr, Fort Wayne, IN 46805 | 2014-07-16 |
| 1083036974 | Capital Senior Living Properties 4, Inc. | Assisted Living Facility | 3320 East State Boulevard, Fort Wayne, IN 46805 | 2014-01-10 |
| 1356772396 | Alexander James Medical Supply | Durable Medical Equipment & Medical Supplies | 2200 Lake Avenue, Suite 290, Fort Wayne, IN 46805 | 2013-12-02 |
| 1043595689 | Randy James Jennings | Pharmacist | 923 Northcrest Business Center, 6-d, Fort Wayne, IN 46805 | 2011-10-14 |
| Find all providers in zip 46805 | ||||
| Taxonomy Code | 207VX0201X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| Specialization | Gynecologic Oncology |
| An obstetrician/gynecologist who provides consultation and comprehensive management of patients with gynecologic cancer, including those diagnostic and therapeutic procedures necessary for the total care of the patient with gynecologic cancer and resulting complications. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437146081 | John P. Geisler | Obstetrics & Gynecology | 2510 E Dupont Rd Ste 236, Fort Wayne, IN 46825-1603 | 2005-09-29 |
| 1326213794 | Robert Martin Ore | Obstetrics & Gynecology | 11050 Parkview Circle Dr, Fort Wayne, IN 46845 | 2008-04-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215198080 | Emma Caroline Rossi | Obstetrics & Gynecology | 1030 W. Michigan St., Indianapolis, IN 46202 | 2008-06-24 |
| 1639343619 | Nabila Rasool | Obstetrics & Gynecology | 8111 S Emerson Ave # 204, Indianapolis, IN 46237 | 2008-04-21 |
| 1386634236 | Paul C Liu | Obstetrics & Gynecology | 100 Navarre Pl Ste 4470, South Bend, IN 46601-1168 | 2005-10-24 |
| 1154317675 | James Robert Dunlop | Obstetrics & Gynecology | 8051 S Emerson Ave Ste 400, Indianapolis, IN 46237-8633 | 2005-09-20 |
| 1437153913 | Michael W Method | Obstetrics & Gynecology | 7979 N Shadeland Ave, Ste 310, Indianapolis, IN 46250-2042 | 2005-06-13 |
| 1821482431 | Beacon Medical Group, Inc. | Obstetrics & Gynecology | 100 Navarre Pl Ste 4470, South Bend, IN 46601-1168 | 2015-03-20 |
| 1053677591 | Sarah Dilley | Obstetrics & Gynecology | 7979 N Shadeland Ave Ste 310, Indianapolis, IN 46250 | 2012-04-10 |
| 1215203559 | Megan Elyse Buechel | Obstetrics & Gynecology | 8402 Harcourt Rd Ste 420, Indianapolis, IN 46260-2053 | 2012-03-30 |
| 1124303466 | Michiana Hematology-oncology P C | Obstetrics & Gynecology | 1205 S Main St, Suite 301, Crown Point, IN 46307-3676 | 2011-10-19 |
| 1487939732 | Michiana Hematology-oncology P C | Obstetrics & Gynecology | 615 N Michigan St, South Bend, IN 46601-1033 | 2011-10-19 |
| Find all providers with the same taxonomy | ||||
| City | FORT WAYNE |
| Zip Code | 46805 |
Please comment or provide details below to improve the information on GYNECOLOGIC ONCOLOGY OF NORTHEAST INDIANA, LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.