NPIMap

Organization Active NPI

Anesthesia Management Services of California Inc

  • Anesthesiology Physician
  • Ukiah, CA
National Provider Identifier
1003458704
Registry record updated Oct 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
ANESTHESIA MANAGEMENT SERVICES OF CALIFORNIA INC
Practice address
275 Hospital Dr
Ukiah, CA 95482-4531
Phone
(707) 463-3111
Fax
(707) 463-7339
NPI assigned
Oct 14, 2019
Last updated
Oct 14, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Samuel ThibodeauxNPI 1578544516
Title
President
Phone
(319) 331-0621

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207L00000X Primary
Certified Registered Nurse AnesthetistGroup: 193200000X MULTI-SPECIALTY GROUP 367500000X

Addresses

Primary practice location

275 Hospital Dr
Ukiah, CA 95482-4531

Mailing address

PO Box 34120
Reno, NV 89533-4120
Phone (775) 747-5050

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200206002375 CA Part B Supplier - Clinic/Group Practice 0840626040 Receives reassigned benefits from 20 practitioners
Practice locations: Ukiah, CA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 20

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 20

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1571011200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1571011200000",
    "number": "1003458704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 34120",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895334120",
            "telephone_number": "775-747-5050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "275 HOSPITAL DR",
            "city": "UKIAH",
            "state": "CA",
            "postal_code": "954824531",
            "telephone_number": "707-463-3111",
            "fax_number": "707-463-7339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANESTHESIA MANAGEMENT SERVICES OF CALIFORNIA INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-14",
        "last_updated": "2019-10-14",
        "status": "A",
        "authorized_official_last_name": "THIBODEAUX",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "319-331-0621"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "367500000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ukiah, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.