MEDICARE: INTEGRATED CARDIOLOGY GROUP LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	207RA0001X	Advanced Heart Failure and Transplant Cardiology Physician
2	207RC0001X	Clinical Cardiac Electrophysiology Physician
3	207RI0011X	Interventional Cardiology Physician
4	2086S0129X	Vascular Surgery Physician
5	208G00000X	Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
6	363AM0700X	Medical Physician Assistant
7	363L00000X	Nurse Practitioner
8	363LA2100X	Acute Care Nurse Practitioner
9	363LA2200X	Adult Health Nurse Practitioner
10	207RC0000X	Cardiovascular Disease Physician

General Provider Information

NPI Number	:	1982653515
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INTEGRATED CARDIOLOGY GROUP LLC

Provider Business Mailing Address
First Line	:	PO BOX 860879
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55486-0879
Country	:	US
Telephone Number	:	402-483-3333
Fax Number	:	402-483-3297

Provider Business Practice Location Address
First Line	:	1600 S 48TH ST
Second Line	:	SUITE 600
City	:	LINCOLN
State	:	NE
Zip	:	68506-1275
Country	:	US
Telephone Number	:	402-483-3333
Fax Number	:	402-483-3297

Authorized Official
Title or Position	:	CHIEF ADMINISTRATIVE OFFICER
Name	:	PHILIP A ZECCARDI
Credential	:
Telephone Number	:	402-483-3333

Provider Enumeration Date	:	05/10/2006
Last Update Date	:	03/14/2024

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Directions to “INTEGRATED CARDIOLOGY GROUP LLC ” Practice Location

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