Individual provider Active NPI

David Mead, M.D.

  • Anesthesiology Physician
  • Fort Worth, TX
National Provider Identifier
1073561957
Registry record updated Sep 23, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
G60990 Issued in CA
Practice address
4916 Overton PLZ
Fort Worth, TX 76109-4415
Phone
(800) 585-0868
Fax
(817) 334-0235
NPI assigned
May 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X G60990 CA Primary

Addresses

Primary practice location

4916 Overton PLZ
Fort Worth, TX 76109-4415

Mailing address

747 Fifty Second Street
Anesthesiology
Oakland, CA 94609-1809
Phone (510) 428-3070

Other identifiers 1

IdentifierTypeStateIssuer
00G609900MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110329000476 CA Practitioner - Anesthesiology 4183521362 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G60990CAMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Childrens Anesthesia Medical Group Inc Anesthesiology CurrentSince Dec 16, 2010 Accepting new patients

Locations

747 52nd St
Oakland, CA 94609
Phone (510) 428-3070

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1146700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1253664000000",
    "number": "1073561957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "747 FIFTY SECOND STREET",
            "address_2": "ANESTHESIOLOGY",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946091809",
            "telephone_number": "510-428-3070",
            "fax_number": "510-450-5853"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4916 OVERTON PLZ",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761094415",
            "telephone_number": "800-585-0868",
            "fax_number": "817-334-0235"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEAD",
        "first_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-04",
        "last_updated": "2009-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "G60990",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G609900",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.