NPIMap

Organization Active NPI

Anesthesia Specialists, PTR

  • Anesthesiology Physician
  • Norfolk, VA
National Provider Identifier
1013910330
Registry record updated Aug 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
168544-R Issued in VA
Legal business name
ANESTHESIA SPECIALISTS, PTR
Practice address
300 E Main St Ste 1300
Norfolk, VA 23510-1756
Phone
(757) 388-3000
NPI assigned
May 31, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2023

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

Authorized official

Name
Nicole J. Wood-Sabo
Title
Practice Administrator
Phone
(757) 567-8832

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207L00000X 168544-R VA Primary

Addresses

Primary practice location

300 E Main St Ste 1300
Norfolk, VA 23510-1756

Mailing address

PO Box 79446
Baltimore, MD 21279-0446
Phone (757) 567-8832

Other identifiers 1

IdentifierTypeStateIssuer
1013910330MedicaidVA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050422000201 VA Part B Supplier - Clinic/Group Practice 8123066891 Receives reassigned benefits from 19 practitioners
Practice locations: Norfolk, VA

National Provider Directory

National Provider Directory

Locations

300 E Main St
Ste 1300
Norfolk, VA 23510
Phone (757) 567-8832

150 Boush St
Ste 1100
Norfolk, VA 23510
Phone (262) 787-4050

138 S Rosemont Rd
Ste 215
Virginia Beach, VA 23452
Phone (757) 431-9551

Practitioners & affiliated clinicians

Practitioners 22

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 22

NPI Registry JSON

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

{
    "created_epoch": "1117497600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692316800000",
    "number": "1013910330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 79446",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212790446",
            "telephone_number": "757-567-8832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 E MAIN ST STE 1300",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235101756",
            "telephone_number": "757-388-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANESTHESIA SPECIALISTS, PTR",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-05-31",
        "last_updated": "2023-08-18",
        "certification_date": "2023-08-18",
        "status": "A",
        "authorized_official_last_name": "WOOD-SABO",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "757-567-8832"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology",
            "state": "VA",
            "license": "168544-R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1013910330",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Norfolk, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2023; 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.