NPIMap

Organization Active NPI

American Anesthesiology of Mississippi LLC

  • Anesthesiology Physician
  • Melville, NY
National Provider Identifier
1023723558
Registry record updated Sep 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
AMERICAN ANESTHESIOLOGY OF MISSISSIPPI LLC
Practice address
1305 Walt Whitman Rd Ste 300
Melville, NY 11747-4300
Phone
(516) 945-3000
NPI assigned
Jan 19, 2023
Last updated
Sep 16, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2024

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

Authorized official

Name
Dewayne Boyd
Title
Manager
Phone
(516) 370-3824

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207L00000X Primary

Addresses

Primary practice location

1305 Walt Whitman Rd Ste 300
Melville, NY 11747-4300

Mailing address

1305 Walt Whitman Rd Ste 300
Melville, NY 11747-4300
Phone (516) 945-3000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230311000163 MS Part B Supplier - Clinic/Group Practice 4789057878 Receives reassigned benefits from 50 practitioners
Practice locations: Southaven, MS

National Provider Directory

National Provider Directory

Locations

7580 Clarington Cv
Southaven, MS 38671
Phone (901) 259-1600

Practitioners & affiliated clinicians

Practitioners 56

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 56

NPI Registry JSON

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

{
    "created_epoch": "1674086400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726444800000",
    "number": "1023723558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1305 WALT WHITMAN RD STE 300",
            "city": "MELVILLE",
            "state": "NY",
            "postal_code": "117474300",
            "telephone_number": "516-945-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1305 WALT WHITMAN RD STE 300",
            "city": "MELVILLE",
            "state": "NY",
            "postal_code": "117474300",
            "telephone_number": "516-945-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMERICAN ANESTHESIOLOGY OF MISSISSIPPI LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-19",
        "last_updated": "2024-09-16",
        "certification_date": "2024-09-16",
        "status": "A",
        "authorized_official_last_name": "BOYD",
        "authorized_official_first_name": "DEWAYNE",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "516-370-3824"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Melville, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2024; 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.