Provider Demographics
NPI:1619072956
Name:SASSO, RICK C (MD)
Entity Type:Individual
Prefix:
First Name:RICK
Middle Name:C
Last Name:SASSO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13225 N MERIDIAN ST
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46032-5480
Mailing Address - Country:US
Mailing Address - Phone:317-228-7000
Mailing Address - Fax:317-228-2321
Practice Address - Street 1:13225 N MERIDIAN ST
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46032-5480
Practice Address - Country:US
Practice Address - Phone:317-228-7000
Practice Address - Fax:317-228-2321
Is Sole Proprietor?:No
Enumeration Date:2006-09-13
Last Update Date:2016-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN0104013A207XS0117X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the Spine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000214081OtherANTHEM PROVIDER NUMBER
INP00847372OtherMEDICARE RR
IN000000214081OtherUNICARE
IN1994398OtherCIGNA PROVIDER NUMBER
IN366735000OtherUS DEPT. OF LABOR
IN000000011599OtherM-PLAN PROVIDER NUMBER
IN000000214081OtherANTHEM PROVIDER NUMBER
INM400069360Medicare PIN
IN000000214081OtherUNICARE