Active NPI
Free State Anesthesia Services LLC
- Anesthesiology Physician
- Berlin, MD
National Provider Identifier
1104744523
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- Legal business name
- FREE STATE ANESTHESIA SERVICES LLC
- Practice address
- 10231 Old Ocean City Blvd Ste 205
Berlin, MD 21811-3568 - Phone
- (914) 491-9495
- NPI assigned
- Jul 6, 2026
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Marc E Koch, MD
- Title
- Authorized Official
- Phone
- (914) 491-9495
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | Primary |
Addresses
Primary practice location
10231 Old Ocean City Blvd Ste 205
Berlin, MD 21811-3568
Mailing address
450 Mamaroneck Ave Ste 201
Harrison, NY 10528-2436
Phone (914) 491-9495
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1783296000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1783296000000",
"number": "1104744523",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "450 MAMARONECK AVE STE 201",
"city": "HARRISON",
"state": "NY",
"postal_code": "105282436",
"telephone_number": "914-491-9495",
"fax_number": "914-365-6326"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10231 OLD OCEAN CITY BLVD STE 205",
"city": "BERLIN",
"state": "MD",
"postal_code": "218113568",
"telephone_number": "914-491-9495"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "FREE STATE ANESTHESIA SERVICES LLC",
"organizational_subpart": "NO",
"enumeration_date": "2026-07-06",
"last_updated": "2026-07-06",
"certification_date": "2026-07-06",
"status": "A",
"authorized_official_last_name": "KOCH",
"authorized_official_first_name": "MARC",
"authorized_official_middle_name": "E",
"authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
"authorized_official_telephone_number": "914-491-9495",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Anesthesiology",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Berlin, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.