HEART GROUP, PC

Provider Demographics

• NPI: 1487624102
• Name: HEART GROUP, PC
• Entity type: Organization
• Organization Name: HEART GROUP, PC
• Other - Org Name: <UNAVAIL>
• Authorized Official - Title/Position: PRESIDENT
• Authorized Official - Prefix: DR
• Authorized Official - First Name: CHANDRASHEKAR
• Authorized Official - Last Name: KUMBAR
• Authorized Official - Credentials: MD
• Authorized Official - Phone: 812-464-9133
• Mailing Address - Street 1: 4015 GATEWAY BLVD
• Mailing Address - Street 2: SUITE 2120
• Mailing Address - City: NEWBURGH
• Mailing Address - State: IN
• Mailing Address - Zip Code: 47630-9460
• Mailing Address - Country: US
• Mailing Address - Phone: 812-842-0907
• Mailing Address - Fax: 812-464-4485
• Practice Address - Street 1: 4015 GATEWAY BLVD
• Practice Address - Street 2: SUITE 2120
• Practice Address - City: NEWBURGH
• Practice Address - State: IN
• Practice Address - Zip Code: 47630-9460
• Practice Address - Country: US
• Practice Address - Phone: 812-842-0907
• Practice Address - Fax: 812-464-4485
• EIN: <UNAVAIL>
• Is Organization Subpart?: No
• Enumeration Date: 2006-01-25
• Last Update Date: 2016-12-15

Provider Licenses

State	License ID	Taxonomies
IN		207RC0001X, 207RI0011X, 2086S0129X, 208G00000X, 207RC0000X
		363AM0700X, 363AS0400X, 363L00000X

Provider Taxonomies

Primary?	Code	Type	Classification	Specialization	Group
Yes	207RC0000X	Allopathic & Osteopathic Physicians	Internal Medicine	Cardiovascular Disease	Group - Multi-Specialty
No	207RC0001X	Allopathic & Osteopathic Physicians	Internal Medicine	Clinical Cardiac Electrophysiology	Group - Multi-Specialty
No	207RI0011X	Allopathic & Osteopathic Physicians	Internal Medicine	Interventional Cardiology	Group - Multi-Specialty
No	2086S0129X	Allopathic & Osteopathic Physicians	Surgery	Vascular Surgery	Group - Multi-Specialty
No	208G00000X	Allopathic & Osteopathic Physicians	Thoracic Surgery (Cardiothoracic Vascular Surgery)		Group - Multi-Specialty
No	363AM0700X	Physician Assistants & Advanced Practice Nursing Providers	Physician Assistant	Medical	Group - Multi-Specialty
No	363AS0400X	Physician Assistants & Advanced Practice Nursing Providers	Physician Assistant	Surgical	Group - Multi-Specialty
No	363L00000X	Physician Assistants & Advanced Practice Nursing Providers	Nurse Practitioner		Group - Multi-Specialty

Provider Identifiers

State	Identifier ID	ID Type	Issuer
IN	100179860	Medicaid
KY	65917130	Medicaid
IN	200512330	Medicaid
IN	200512330	Medicaid
IN	204060	Medicare PIN
IN	CF8429	Medicare PIN
KY	65917130	Medicaid
KY	CB9947	Medicare PIN
KY	CA3845	Medicare PIN
IL	947850	Medicare PIN
IL	CG7181	Medicare PIN
IN	532500	Medicare PIN
IN	100179860	Medicaid
IN	178910	Medicare PIN