Apollo Medical Group of Upper Bay LLC
Organization Active NPI Anesthesiology Physician · Elkton, MD
NPI 1114496759 · NPPES record last updated Apr 5, 2023
Key facts
- NPI
- 1114496759
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Anesthesiology Physician 207L00000X
- Legal business name
- APOLLO MEDICAL GROUP OF UPPER BAY LLC
- Practice address
- 360 E Pulaski Hwy Ste 2a
Elkton, MD 21921-6595 - Phone
- (410) 620-3348
- Fax
- (410) 620-3351
- NPI assigned
- Nov 13, 2018
- Organization subpart
- No
Authorized official
- Name
- Robin Van Sprundel
- Title
- Director of Administration
- Phone
- (941) 725-1198
Practitioners 14
-
Hamid A. Anhary, MD
-
Cecilia Carroll, CRNA
-
Ha T Le, M.D.
-
Marleen McKenzie, M.D.
-
Ali Razi, MD
-
Sami Badri, M.D.
-
Christopher Ogbin, CRNA
-
David E Levy, MD
-
Elizabeth Mary Mackey, CRNA
-
Kevin Oh, M.D.
-
Amavi E. Pitts, CRNA
-
Allen Plaskett, CRNA
-
Stephen A Sardino Jr., M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MD
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20190218000235 | MD | Part B Supplier - Clinic/Group Practice | 5395083356 |
Receives reassigned benefits from 14 practitioners Practice locations: Elkton, MD |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician |
207L00000X | Yes | ||
| Certified Registered Nurse Anesthetist |
367500000X |
Addresses
Primary practice location
360 E Pulaski Hwy Ste 2a
Elkton, MD 21921-6595
Mailing address
PO Box 2985
Springfield, IL 62708-2985
Phone (941) 360-1566
Other providers in Elkton, MD
- Angela Coleman NP LLC
- Maria Angelucci
- Janelle Kristen Antonio
- Berkeley Harbour Antonioli
- Apex Healthcare, LLC
- Arpan N. Patel DMD LLC
- Arrison Anesthesia LLC
- Tammy Schouppe Asher
- Amber Leigh Ashley
- Ashley, Inc.
All providers in Elkton, MD · Anesthesiology Physician in Maryland
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 5, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.