NPIMap

Organization Active NPI

Surgery Center Anesthesia Providers PC

  • Certified Registered Nurse Anesthetist
  • Williamsburg, VA
National Provider Identifier
1073807376
Registry record updated Jan 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
Legal business name
SURGERY CENTER ANESTHESIA PROVIDERS PC
Practice address
5215 Monticello Ave
Williamsburg, VA 23188-8232
Phone
(757) 229-4000
Fax
(952) 442-3620
NPI assigned
Jun 3, 2011
Last updated
Jan 24, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2023

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

Authorized official

Name
Samuel Lecates, CRNANPI 1790788396
Title
Owner
Phone
(336) 420-7472

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X Primary
Anesthesiology Physician 207L00000X

Addresses

Primary practice location

5215 Monticello Ave
Williamsburg, VA 23188-8232

Mailing address

7269 Trotters Run
Trinity, NC 27370-7394
Phone (800) 204-0099

Other practice location 1

1000 Centre Brook Ct
Columbus, GA 31904-4573
Phone (336) 472-7289

Other practice location 2

2010 Bremo Rd Ste 132
Richmond, VA 23226-2444
Phone (804) 285-0680

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, NC, VA, TX4 enrollments

Enrollment records 4

Enrollment IDStateProvider typePAC IDDetails
O20110706000331 GA Part B Supplier - Clinic/Group Practice 5395923700 Receives reassigned benefits from 5 practitioners
Practice locations: Conyers, GA
O20120406000016 NC Part B Supplier - Clinic/Group Practice 5395923700 Receives reassigned benefits from 41 practitioners
Practice locations: Charlotte, NC; Wilmington, NC
O20190516002751 VA Part B Supplier - Clinic/Group Practice 5395923700 Receives reassigned benefits from 25 practitioners
Practice locations: Forest, VA; Richmond, VA; Williamsburg, VA; Winchester, VA
O20251028001505 TX Part B Supplier - Clinic/Group Practice 5395923700 Receives reassigned benefits from 8 practitioners
Practice locations: Texarkana, TX; Tyler, TX

National Provider Directory

National Provider Directory

Locations

475D by Pass 123
Seneca, SC 29678
Phone (864) 882-8850

475D by Pass 123
Seneca, SC 29678
Phone (864) 882-8850

1802 Moores Ln
Texarkana, TX 75503
Phone (903) 306-0711

1040 Main St
Danville, VA 24541
Phone (434) 792-1433

Practitioners & affiliated clinicians

Practitioners 104

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 104

NPI Registry JSON

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

{
    "created_epoch": "1307059200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1674518400000",
    "number": "1073807376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7269 TROTTERS RUN",
            "city": "TRINITY",
            "state": "NC",
            "postal_code": "273707394",
            "telephone_number": "800-204-0099",
            "fax_number": "336-882-2216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5215 MONTICELLO AVE",
            "city": "WILLIAMSBURG",
            "state": "VA",
            "postal_code": "231888232",
            "telephone_number": "757-229-4000",
            "fax_number": "952-442-3620"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1000 Centre Brook Ct",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "GA",
            "postal_code": "319044573",
            "country_code": "US",
            "telephone_number": "336-472-7289",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2010 Bremo Rd Ste 132",
            "address_purpose": "LOCATION",
            "city": "Richmond",
            "state": "VA",
            "postal_code": "232262444",
            "country_code": "US",
            "telephone_number": "804-285-0680",
            "fax_number": "952-442-3620",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SURGERY CENTER ANESTHESIA PROVIDERS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-03",
        "last_updated": "2023-01-24",
        "certification_date": "2023-01-24",
        "status": "A",
        "authorized_official_last_name": "LECATES",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "336-420-7472",
        "authorized_official_credential": "CRNA"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Williamsburg, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2023; 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.