DR. PETER CACCAVALLO (NPI# 1205987252) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205987252 |
| Entity Type | Individual |
| Full Name | DR. PETER CACCAVALLO |
| Practice Address |
13000 E 136th St Suite 1100 Fishers IN 46037-9478 |
| Practice Telephone | 3176783585 |
| Practice Fax Number | 3178635084 |
| Mailing Telephone | 3176783585 |
| Mailing Fax Number | 3178635084 |
| Enumeration Date | 2007-01-16 |
| Last Update Date | 2014-07-14 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | 1053181A | IN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | ANTHEM ID NUMBER | 000000287592 | 01 |
| IN | RAILROAD MEDICARE | P00013960 | 01 |
| IN | 200316800 | 05 | |
| IN | TAX ID | 51-0456750 | 01 |
| Street Address |
13000 E 136TH ST SUITE 1100 |
| City | FISHERS |
| State | IN |
| Zip Code | 46037-9478 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033157599 | Gaurav Arora | Emergency Medicine | 13000 E 136th St, Fishers, IN 46037-9478 | 2006-06-04 |
| 1215440334 | Matthieu Zingg | Orthopaedic Surgery | 13000 E 136th St, Fishers, IN 46037-9478 | 2017-11-10 |
| 1205369923 | Marzieh T Naderi | Registered Nurse | 13000 E 136th St, Fishers, IN 46037-9478 | 2017-04-10 |
| 1316499940 | Shelby Miller | Physician Assistant | 13000 E 136th St, Ste. 1100, Fishers, IN 46037-9478 | 2016-10-31 |
| 1720539075 | Indianapolis Perioperative Medicine | Physician Assistant | 13000 E 136th St, Ste. 1100, Fishers, IN 46037-9478 | 2016-10-21 |
| 1184902447 | Rory Paul Sandberg | Orthopaedic Surgery | 13000 E 136th St, Fishers, IN 46037 | 2011-08-03 |
| 1720285976 | Indianapolis Perioperative Medicine, LLC | Internal Medicine | 13000 E 136th St, Suite 1100, Fishers, IN 46037-9478 | 2007-06-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659994200 | Lake Meadows Licensee LLC | Assisted Living Facility | 11570 E 126th Street, Fishers, IN 46037 | 2020-05-18 |
| 1861059818 | Fishers Specialty Surgery Center, LLC | Clinic/Center | 14300 E 138th St, Fishers, IN 46037 | 2019-05-24 |
| 1033776604 | Diane M Gianfagna-meils | Reflexologist | 9117 Thoreau Court, Fishers, IN 46037 | 2019-05-20 |
| 1649796830 | Heartland Medical, LLC | Durable Medical Equipment & Medical Supplies | 12289 Harvest Glen Blvd, Fishers, IN 46037 | 2017-08-18 |
| 1578098703 | Galaxy Healthcare Services LLC | Home Health | 12262 Steepleview Ct, Fishers, IN 46037 | 2017-04-25 |
| 1386980472 | Brenda Lynn Thompson | Counselor | 8880 Jaywick Dr Apt 206, Fishers, IN 46037 | 2012-12-18 |
| 1972887941 | Molly E Bruvold | Pharmacist | 13741 East 116th Street, Fishers, IN 46037 | 2011-10-07 |
| 1588970867 | Marie C. Holt, Dds | Dentist | 7862 E. 96th St., Fishers, IN 46037 | 2010-08-25 |
| 1114157815 | Francis Edward Mcaree Jr. | Obstetrics & Gynecology | 10907 300 Yd. Dr, Fishers, IN 46037 | 2009-07-16 |
| 1740433820 | Robert Gerald Klitzman | Orthopaedic Surgery | 13100 E. 136th St., Suite 2000, Fishers, IN 46037 | 2008-11-03 |
| Find all providers in zip 46037 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417315102 | Healthy Aging Enterprise, LLC | Internal Medicine | 10926 Belle Plaine Blvd, Fishers, IN 46037-7113 | 2016-02-09 |
| 1457743684 | Doorstepmd LLC | Internal Medicine | 12045 Bodley Pl, Fishers, IN 46037-3714 | 2015-02-25 |
| 1639384183 | Kevin Michael Logan | Internal Medicine | 8499 Fishers Center Dr., Fishers, IN 46038-2318 | 2007-05-10 |
| 1588773154 | American Health Network of Indiana, LLC | Internal Medicine | 10995 Allisonville Rd, Suite 100, Fishers, IN 46038-2616 | 2006-08-29 |
| 1598716458 | Steven D Hill | Internal Medicine | 13100 136th Street, Suite 3400, Iu Saxony Hospital, Fishers, IN 46237 | 2006-05-15 |
| 1922058684 | Sunil J Juthani | Internal Medicine | 13100 E 136th St Ste 3400, Iu Saxony Hospital, Fishers, IN 46037-9818 | 2006-05-11 |
| 1538118849 | Brett M Mccullough | Internal Medicine | 13861 Olio Rd, Fishers, IN 46037-3487 | 2006-05-06 |
| 1528041852 | Juanita Yoder Albright | Internal Medicine | 13914 Southeastern Pkwy Ste 108, Fishers, IN 46037-7124 | 2005-11-21 |
| 1033119441 | Aaron Gunnar Shoemaker | Internal Medicine | 11530 Allisonville Rd Ste 100, Fishers, IN 46038-1862 | 2005-07-28 |
| 1972894939 | Brittany Mohrman | Internal Medicine | 13100 E 136th St, Suite 1200, Fishers, IN 46037-9417 | 2011-04-26 |
| Find all providers in FISHERS | ||||
Please comment or provide details below to improve the information on DR. PETER CACCAVALLO.
| 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.