Apollo Medical Group of Portsmouth PLLC

Organization Active NPI Anesthesiology Physician · Newington, NH

NPI 1023780657 · NPPES record last updated Mar 30, 2023

Key facts

NPI
1023780657
Entity type
Organization (NPI type 2)
Primary specialty
Anesthesiology Physician 207L00000X
Legal business name
APOLLO MEDICAL GROUP OF PORTSMOUTH PLLC
Practice address
291 Shattuck Way
Newington, NH 03801-7869
Phone
(561) 330-3381
Fax
(561) 330-3382
NPI assigned
Oct 1, 2021
Organization subpart
No

Authorized official

Name
Robin Van Sprundel
Title
Director of Administration
Phone
(941) 725-1198

Practitioners 22

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

Medicare participation

Medicare fee-for-service enrollment
Enrolled in NH

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20211130003135 NH Part B Supplier - Clinic/Group Practice 9032509344 Receives reassigned benefits from 22 practitioners
Practice locations: Newington, NH

National Provider Directory

Locations

291 Shattuck Way
Portsmouth, NH 03801
Phone (561) 330-3381

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician
Group: 193200000X MULTI-SPECIALTY GROUP
207L00000X Yes
Certified Registered Nurse Anesthetist
Group: 193200000X MULTI-SPECIALTY GROUP
367500000X

Addresses

Primary practice location

291 Shattuck Way
Newington, NH 03801-7869

Mailing address

PO Box 20848
Springfield, IL 62708-0848
Phone (941) 360-1566

Other providers in Newington, NH

All providers in Newington, NH · Anesthesiology Physician in New Hampshire

Sources for this page

Verify at the official NPI Registry.