NPIMap

Organization Active NPI

Repose Anesthesia PC

  • Certified Registered Nurse Anesthetist
  • Riverside, CA
National Provider Identifier
1053282962
Registry record updated Sep 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
Legal business name
REPOSE ANESTHESIA PC
Practice address
4234 Riverwalk Pkwy Ste 230
Riverside, CA 92505-3312
Phone
(951) 509-9204
NPI assigned
Sep 15, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2025

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

Authorized official

Name
Andrew Lim, CRNANPI 1568934818
Title
President
Phone
(951) 323-4945

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse AnesthetistGroup: 193400000X SINGLE SPECIALTY GROUP 367500000X Primary

Addresses

Primary practice location

4234 Riverwalk Pkwy Ste 230
Riverside, CA 92505-3312

Mailing address

17050 Limetree LN
Riverside, CA 92503-6770
Phone (951) 323-4945

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260131000794 CA Part B Supplier - Clinic/Group Practice 2860978616 Receives reassigned benefits from 7 practitioners
Practice locations: Newport Beach, CA; Riverside, CA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 7

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": "1757894400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757894400000",
    "number": "1053282962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17050 LIMETREE LN",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925036770",
            "telephone_number": "951-323-4945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4234 RIVERWALK PKWY STE 230",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925053312",
            "telephone_number": "951-509-9204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REPOSE ANESTHESIA PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-09-15",
        "last_updated": "2025-09-15",
        "certification_date": "2025-09-15",
        "status": "A",
        "authorized_official_last_name": "LIM",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "951-323-4945",
        "authorized_official_credential": "CRNA"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverside, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 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.