NPIMap

Organization Active NPI

Ophthalmic Anesthesia Team PA

  • Certified Registered Nurse Anesthetist
  • Wichita, KS
National Provider Identifier
1013952126
Registry record updated Aug 27, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
Legal business name
OPHTHALMIC ANESTHESIA TEAM PA
Practice address
6100 East Central
Ste 5
Wichita, KS 67212
Phone
(316) 681-2020
NPI assigned
Jun 20, 2006
Last updated
Aug 27, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2008

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

Authorized official

Name
Michael Gene Gerberding, CRNANPI 1962471086
Title
President
Phone
(316) 681-2020

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

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

Addresses

Primary practice location

6100 East Central
Ste 5
Wichita, KS 67212

Mailing address

PO Box 388
Newton, KS 67114-0388
Phone (316) 281-3700

Other identifiers 2

IdentifierTypeStateIssuer
111237OtherKSBCBS
200376810AMedicaidKS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060808000563 KS Part B Supplier - Clinic/Group Practice 3678576808 Receives reassigned benefits from 5 practitioners
Practice locations: Hutchinson, KS; Wichita, KS

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1150761600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1219795200000",
    "number": "1013952126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 388",
            "city": "NEWTON",
            "state": "KS",
            "postal_code": "671140388",
            "telephone_number": "316-281-3700",
            "fax_number": "316-282-4322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6100 EAST CENTRAL",
            "address_2": "STE 5",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "67212",
            "telephone_number": "316-681-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPHTHALMIC ANESTHESIA TEAM PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-20",
        "last_updated": "2008-08-27",
        "status": "A",
        "authorized_official_last_name": "GERBERDING",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "GENE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "316-681-2020",
        "authorized_official_credential": "CRNA"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "111237",
            "state": "KS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200376810A",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wichita, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2008; 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.