Organization Active NPI

Free State Anesthesia Services LLC

  • Anesthesiology Physician
  • Berlin, MD
National Provider Identifier
1104744523
Registry record updated Jul 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
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

Updated by the provider on Jul 6, 2026

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)CodeLicenseStatePrimary
Anesthesiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 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 Directory

NPI 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.

Verify at the official NPI Registry.