Provider Demographics
NPI:1457551095
Name:NEW HOPE ORTHOPAEDICS AND SPORTS MEDICINE PC
Entity Type:Organization
Organization Name:NEW HOPE ORTHOPAEDICS AND SPORTS MEDICINE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:PEGGY
Authorized Official - Middle Name:B
Authorized Official - Last Name:MINDREBO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-770-1700
Mailing Address - Street 1:13421 OLD MERIDIAN ST
Mailing Address - Street 2:SUITE 202
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46032-1427
Mailing Address - Country:US
Mailing Address - Phone:317-770-1700
Mailing Address - Fax:317-770-1727
Practice Address - Street 1:13421 OLD MERIDIAN ST
Practice Address - Street 2:SUITE 202
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46032-1427
Practice Address - Country:US
Practice Address - Phone:317-815-1700
Practice Address - Fax:317-770-1700
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-23
Last Update Date:2009-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01036857A207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN5445940003Medicare NSC
IN221620DMedicare PIN
IN221620EMedicare PIN
IN221620Medicare PIN
IN221620BMedicare PIN
IN221620AMedicare PIN