NORTHEAST INDIANA COLON RECTAL SURGEONS PC (NPI# 1912998014) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912998014 |
| Entity Type | Organization |
| Organization Name | NORTHEAST INDIANA COLON RECTAL SURGEONS PC |
| Practice Address |
11141 Parkview Plaza Dr Suite 310 Fort Wayne IN 46845-1701 |
| Practice Telephone | 2604898898 |
| Practice Fax Number | 2603734695 |
| Mailing Telephone | 2604898898 |
| Mailing Fax Number | 2603734695 |
| Enumeration Date | 2005-10-31 |
| Last Update Date | 2008-02-28 |
| Authorized Official Name | PAUL J. RAIMAN (OWNER/PRACTITIONER) |
| Authorized Official Telephone | 2604898898 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208C00000X | Colon & Rectal Surgery | 50004032A | IN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OH | 2053852 | 05 |
| Street Address |
11141 PARKVIEW PLAZA DR SUITE 310 |
| City | FORT WAYNE |
| State | IN |
| Zip Code | 46845-1701 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811999840 | William R Cast | Otolaryngology | 11141 Parkview Plaza Dr, Suite 210, Fort Wayne, IN 46845-1701 | 2005-08-10 |
| 1891236568 | Emily Kyburz | Dietitian, Registered | 11141 Parkview Plaza Dr, Ste 305b, Fort Wayne, IN 46845-1713 | 2017-03-15 |
| 1629440193 | Sarah Weaver | Nurse Practitioner | 11141 Parkview Plaza Dr, Suite 210, Fort Wayne, IN 46845-1713 | 2015-10-23 |
| 1730563255 | Chelsea Rentschler | Nurse Practitioner | 11141 Parkview Plaza Dr, Suite 305, Fort Wayne, IN 46845-1713 | 2015-07-14 |
| 1699171975 | Taylor Hill | Nurse Practitioner | 11141 Parkview Plaza Dr, Suite 305, Fort Wayne, IN 46845-1713 | 2014-11-13 |
| 1174926919 | Debra Brice | Nurse Practitioner | 11141 Parkview Plaza Dr, Suite 305, Fort Wayne, IN 46845-1713 | 2014-10-08 |
| 1548661184 | Beth Burns | Nurse Practitioner | 11141 Parkview Plaza Dr, Suite 305, Fort Wayne, IN 46845-1713 | 2014-09-15 |
| 1346641644 | Grant Paul Tyler | Nurse Practitioner | 11141 Parkview Plaza Dr, Suite 305, Fort Wayne, IN 46845-1713 | 2014-09-06 |
| 1417383217 | Elizabeth A Daseler | Nurse Practitioner | 11141 Parkview Plaza Dr, Suite 305, Fort Wayne, IN 46845-1713 | 2013-09-25 |
| 1689922403 | Amanda Michelle Bolin | Dietitian, Registered | 11141 Parkview Plaza Dr, Suite 210, Fort Wayne, IN 46845-1713 | 2012-08-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881154110 | Nancy Jean Ehmke | Clinical Nurse Specialist | 11151 Parkview Plaza Dr, Fort Wayne, IN 46845 | 2019-03-22 |
| 1043703903 | Kara Stackhouse | Nurse Practitioner | 11050 Parkview Plaza Drive, Fort Wayne, IN 46845 | 2018-06-14 |
| 1871082412 | Tara K Jellison | Pharmacist | 11109 Parkview Plaza Drive -- Attn Pharmacy, Fort Wayne, IN 46845 | 2018-05-09 |
| 1578097572 | Forefront Dermatology, S.c. | Dermatology | 4020 New Vision Drive, Fort Wayne, IN 46845 | 2017-04-17 |
| 1811437999 | Jessica Ann Lefever | Behavioral Analyst | 3898 New Vision Dr Ste D, Fort Wayne, IN 46845 | 2017-03-08 |
| 1033668041 | Bhi Home Care, Inc. | In Home Supportive Care | 820 Mill Lake Road, Fort Wayne, IN 46845 | 2016-10-03 |
| 1467814939 | Austin Wyss | Specialist/Technologist | 11130 Parkview Circle Drive, Ft. Wayne, IN 46845 | 2016-03-24 |
| 1154713584 | Ashley Whitcraft | Specialist/Technologist | 11130 Parkview Plaza Drive #4, Fort Wayne, IN 46845 | 2015-02-23 |
| 1275975682 | Lakshmi Mohan Viji Das | Internal Medicine | 11143 Parkview Plaza Dr Ste 311, Fort Wayne, IN 46845 | 2013-07-26 |
| 1336482496 | Mithun Mohana Shenoi | Colon & Rectal Surgery | 11104 Parkview Circle Drive Suite 320, Fort Wayne, IN 46845 | 2013-03-27 |
| Find all providers in zip 46845 | ||||
| Taxonomy Code | 208C00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Colon & Rectal Surgery |
| A colon and rectal surgeon is trained to diagnose and treat various diseases of the intestinal tract, colon, rectum, anal canal and perianal area by medical and surgical means. This specialist also deals with other organs and tissues (such as the liver, urinary and female reproductive system) involved with primary intestinal disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Colon and Rectal Surgery, 2007. http://www.abcrs.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Colon and Rectal Surgery. Colon and rectal surgeons have the expertise to diagnose and often manage anorectal conditions such as hemorrhoids, fissures (painful tears in the anal lining), abscesses and fistulae (infections located around the anus and rectum) in the office setting. They also treat problems of the intestine and colon, and perform endoscopic procedures to evaluate and treat problems such as cancer, polyps (precancerous growths) and inflammatory conditions. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336482496 | Mithun Mohana Shenoi | Colon & Rectal Surgery | 11104 Parkview Circle Drive Suite 320, Fort Wayne, IN 46845 | 2013-03-27 |
| 1568795409 | Center for Colon and Rectal Care LLC | Colon & Rectal Surgery | 12012 Wood Glen Dr, Fort Wayne, IN 46814-4515 | 2009-09-10 |
| 1740689207 | Associated Surgeons & Physicians, LLC | Colon & Rectal Surgery | 7910 W Jefferson Blvd, Suite 305, Fort Wayne, IN 46804-4159 | 2014-08-20 |
| 1639451578 | Vemuru Sunil Kumar Reddy | Colon & Rectal Surgery | 11104 Parkview Circle Dr Ste 320, Fort Wayne, IN 46845-1672 | 2011-09-16 |
| 1104026657 | Colon-rectal Surgeons of Fort Wayne, PC | Colon & Rectal Surgery | 7900 W Jefferson Blvd, Suite 302, Fort Wayne, IN 46804-4128 | 2007-07-23 |
| 1598961393 | Joshua Michael Wallet | Colon & Rectal Surgery | 7988 W Jefferson Blvd, Fort Wayne, IN 46804-4140 | 2007-06-27 |
| 1265636138 | Charles Lamont Morrison | Colon & Rectal Surgery | 7988 W Jefferson Blvd, Fort Wayne, IN 46804-4140 | 2007-06-13 |
| 1477676658 | Hisham S Elhassan | Colon & Rectal Surgery | 11141 Parkview Plaza Dr, Suite 310, Fort Wayne, IN 46845-1701 | 2007-04-10 |
| 1346336575 | Glenn L Goldstein | Colon & Rectal Surgery | 7900 W Jefferson Blvd, Suite 302, Fort Wayne, IN 46804-4128 | 2006-10-05 |
| 1821184052 | Nadine L Floyd | Colon & Rectal Surgery | 7988 W Jefferson Blvd, Fort Wayne, IN 46804-4140 | 2006-10-05 |
| Find all providers in FORT WAYNE | ||||
| City | FORT WAYNE |
| Zip Code | 46845 |
Please comment or provide details below to improve the information on NORTHEAST INDIANA COLON RECTAL 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.