NPIMap

Organization Active NPI

St. Lucie Anesthesia Associates, LLC

  • Anesthesiology Physician
  • Port St Lucie, FL
National Provider Identifier
1043882848
Registry record updated Aug 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
ST. LUCIE ANESTHESIA ASSOCIATES, LLC
Practice address
10080 SW Innovation Way Ste 101
Port St Lucie, FL 34987-2129
Phone
(877) 328-1119
NPI assigned
Jul 13, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2025

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

Authorized official

Name
Christopher Kennedy
Title
Authorized Official
Phone
(207) 807-9008

Specialties & licenses 1

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

Addresses

Primary practice location

10080 SW Innovation Way Ste 101
Port St Lucie, FL 34987-2129

Mailing address

PO Box 745923
Atlanta, GA 30374-5923

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20081027000765 FL Part B Supplier - Clinic/Group Practice 4284792706 Receives reassigned benefits from 239 practitioners
18 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: North Miami Beach, FL; Port St Lucie, FL; Oakland Park, FL; Lady Lake, FL; Hollywood, FL; Delray Beach, FL; Deerfield Beach, FL; Boca Raton, FL

Other NPIs on the same Medicare enrollment 18

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 18

National Provider Directory

National Provider Directory
Tax ID family
St Lucie Anesthesia Associates LLC12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 11

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

NPI Registry JSON

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

{
    "created_epoch": "1626134400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1754438400000",
    "number": "1043882848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 745923",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303745923"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10080 SW INNOVATION WAY STE 101",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349872129",
            "telephone_number": "877-328-1119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. LUCIE ANESTHESIA ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-13",
        "last_updated": "2025-08-06",
        "certification_date": "2025-08-06",
        "status": "A",
        "authorized_official_last_name": "KENNEDY",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "207-807-9008"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port St Lucie, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2025; 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.