Organization Active NPI

St. Marys Anesthesiology Group, L.P.

  • Specialist
  • St Marys, PA
National Provider Identifier
1104867563
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
ST. MARYS ANESTHESIOLOGY GROUP, L.P.
Practice address
1376 Bucktail Rd
St Marys, PA 15857-3212
Phone
(814) 834-7065
NPI assigned
Jun 9, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Shawna Pistner
Title
Biller
Phone
(814) 834-7065

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X Primary

Addresses

Primary practice location

1376 Bucktail Rd
St Marys, PA 15857-3212

Mailing address

1376 Bucktail Rd
St Marys, PA 15857-3212
Phone (814) 834-7065

Other identifiers 1

IdentifierTypeStateIssuer
1014543500001MedicaidPA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1149811200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1104867563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1376 BUCKTAIL RD",
            "city": "ST MARYS",
            "state": "PA",
            "postal_code": "158573212",
            "telephone_number": "814-834-7065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1376 BUCKTAIL RD",
            "city": "ST MARYS",
            "state": "PA",
            "postal_code": "158573212",
            "telephone_number": "814-834-7065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. MARYS ANESTHESIOLOGY GROUP, L.P.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-09",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PISTNER",
        "authorized_official_first_name": "SHAWNA",
        "authorized_official_title_or_position": "BILLER",
        "authorized_official_telephone_number": "814-834-7065"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1014543500001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in St Marys, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.