PETRUNGARO PLASTIC SURGERY, LLC
NPI 1639577794
Surgery - Plastic and Reconstructive Surgery in Munster, IN

Q: What is Petrungaro Plastic Surgery, LLC's NPI number?

The NPI number for Petrungaro Plastic Surgery, LLC is 1639577794. It was assigned to this organization in the NPPES registry on December 5, 2014.

Q: What is Petrungaro Plastic Surgery, LLC's specialty?

The primary specialty registered for this NPI is Surgery, specializing in Plastic and Reconstructive Surgery, with taxonomy code 2086S0122X.

Active since December 05, 2014

800 MACARTHUR BLVD STE 21, MUNSTER, IN 46321(219) 836-1163 Get Directions Write a Review

NPPES record last updated: May 8, 2015. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Petrungaro Plastic Surgery, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PETRUNGARO PLASTIC SURGERY, LLC (NPI 1639577794) is a healthcare organization registered as a plastic and reconstructive surgery in Munster, Indiana and active in the NPI registry since December 2014. The organization lists Jason M Petrungaro, President, as its authorized official.

NPPES Registry Identity

NPI1639577794

Entity TypeOrganization

Primary Taxonomy2086S0122X

Legal Business NamePETRUNGARO PLASTIC SURGERY, LLC

Location Address800 MACARTHUR BLVD STE 21Munster, IN 46321-2918

Mailing Address800 Macarthur Blvd Ste 21Munster, IN 46321-2918 · (219) 836-1163

Phone(219) 836-1163

Organization SubpartNo

Authorized OfficialJason M PetrungaroPresident · (219) 836-1163

Enumeration DateDecember 5, 2014

Last NPPES UpdateMay 8, 2015

✔ NPI 1639577794 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySurgery · Plastic and Reconstructive SurgeryAllopathic & Osteopathic Physicians

Taxonomy Code2086S0122X

License✔ Licensed in IN · 01074460A

Definition

A surgeon who specializes in plastic and reconstructive surgery.

800 MACARTHUR BLVD STE 21, Munster, IN 46321

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Other Identifiers 4

Other914915IN · Bcbs

Medicare PININ2244IN

Other9183790IN · Aetna

Other5410211IN · Cigna

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Petrungaro Plastic Surgery, LLC's NPI number?

The NPI number for Petrungaro Plastic Surgery, LLC is 1639577794. It was assigned to this organization in the NPPES registry on December 5, 2014.

Where is Petrungaro Plastic Surgery, LLC located?

Petrungaro Plastic Surgery, LLC is located at 800 Macarthur Blvd Ste 21, Munster, IN 46321. The listed phone number is (219) 836-1163.

What is Petrungaro Plastic Surgery, LLC's specialty?

The primary specialty registered for this NPI is Surgery, specializing in Plastic and Reconstructive Surgery, with taxonomy code 2086S0122X.

When was this NPI record last updated?

The NPPES record for Petrungaro Plastic Surgery, LLC was last updated on May 8, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.