FORT WAYNE CARDIOVASCULAR SURGEONS, PC (NPI# 1679551741) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679551741 |
| Entity Type | Organization |
| Organization Name | FORT WAYNE CARDIOVASCULAR SURGEONS, PC |
| Practice Address |
1818 Carew St Suite 250 Fort Wayne IN 46805-4788 |
| Practice Telephone | 2604836448 |
| Practice Fax Number | 2603734167 |
| Mailing Telephone | 2604836448 |
| Mailing Fax Number | 2603734167 |
| Enumeration Date | 2006-01-09 |
| Last Update Date | 2007-10-22 |
| Authorized Official Name | DOUGLAS L GRAY (PRESIDENT) |
| Authorized Official Telephone | 2604836448 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | TRAVELERS MEDICARE | C15472 | 01 |
| 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 |
| 1295141380 | Gynecologic Oncology of Northeast Indiana, LLC | Obstetrics & Gynecology | 1818 Carew St, Suite 250, Fort Wayne, IN 46805-4788 | 2014-07-09 |
| 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 |
| 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 | 208G00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Thoracic Surgery (Cardiothoracic Vascular Surgery) |
| A thoracic surgeon provides the operative, perioperative and critical care of patients with pathologic conditions within the chest. Included is the surgical care of coronary artery disease, cancers of the lung, esophagus and chest wall, abnormalities of the trachea, abnormalities of the great vessels and heart valves, congenital anomalies, tumors of the mediastinum and diseases of the diaphragm. The management of the airway and injuries of the chest is within the scope of the specialty. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Thoracic Surgery, 2007. http://www.abts.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Thoracic Surgery. Thoracic surgeons have the knowledge, experience and technical skills to accurately diagnose, operate upon safely, and effectively manage patients with thoracic diseases of the chest. This requires substantial knowledge of cardiorespiratory physiology and oncology, as well as capability in the use of heart assist devices, management of abnormal heart rhythms and drainage of the chest cavity, respiratory support systems, endoscopy and invasive and noninvasive diagnostic techniques. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114122488 | Hannah Copeland | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 7910 W Jefferson Blvd Ste 102, Fort Wayne, IN 46804-4159 | 2007-06-18 |
| 1356544308 | Melmar LLC | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 2410 N Glendale Dr, Suite C, Fort Wayne, IN 46804-8908 | 2007-06-07 |
| 1578655494 | Marcus A Jimenez | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 2510 N Glendale Drive, Suite C, Fort Wayne, IN 46804 | 2006-09-28 |
| 1639171499 | John R Stanford | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 2414 E State Blvd, Carew Building #1, Suite 201, Fort Wayne, IN 46805-4760 | 2005-08-11 |
| 1154616175 | Tariq Omar Lescouflair | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 11108 Parkview Circle Dr Ste 5100, Fort Wayne, IN 46845 | 2011-06-17 |
| 1699975342 | Christopher J. Gullett | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 7910 W Jefferson Blvd Ste 102, Fort Wayne, IN 46804-4159 | 2007-07-20 |
| 1205989159 | Fort Wayne Cardiovascular Associates | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 11123 Parkview Plaza Dr, Suite 202, Fort Wayne, IN 46845-1707 | 2007-01-22 |
| 1215080692 | Fort Wayne Cardiovascular Associates | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 800 Broadway, Suite 201, Fort Wayne, IN 46802-2149 | 2007-01-19 |
| 1790718765 | Fort Wayne Cardiovascular Surgeon | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 11123 Parkview Plaza Dr, Suite 202, Fort Wayne, IN 46845-1707 | 2006-07-10 |
| 1972594968 | Allied Physicians Inc., D/b/a Indiana Ohio Heart | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 2414 E State Blvd, Carew Building, Fort Wayne, IN 46805-4760 | 2005-10-31 |
| Find all providers in FORT WAYNE | ||||
| City | FORT WAYNE |
| Zip Code | 46805 |
Please comment or provide details below to improve the information on FORT WAYNE CARDIOVASCULAR SURGEONS, PC.
| 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.