Apollo Medical Group of Upper Bay LLC

Primary specialty

Anesthesiology PhysicianTaxonomy code 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

Last updated

Apr 5, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Robin Van Sprundel

Title

Director of Administration

Phone

(941) 725-1198

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MD

Enrollment records 1

Practitioners 14

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.

• Hamid A. Anhary, MD

  • Anesthesiology Physician
  • Prince Frederick, MD
  • NPI 1376515320
  Medicare reassignment NPD
• Cecilia Carroll, CRNA

  • Certified Registered Nurse Anesthetist
  • Elkton, MD
  • NPI 1578667143

  Anesthesiology

  Medicare reassignment NPD
• Ha T Le, M.D.

  • Anesthesiology Physician
  • Glen Burnie, MD
  • NPI 1215939103
  Medicare reassignment NPD
• Marleen McKenzie, M.D.

  • Anesthesiology Physician
  • Columbia, MD
  • NPI 1831221621
  Medicare reassignment NPD
• Ali Razi, MD

  • Anesthesiology Physician
  • Frederick, MD
  • NPI 1932116241
  Medicare reassignment NPD
• Sami Badri, M.D.

  • Anesthesiology Physician
  • Reston, VA
  • NPI 1245550326

  MD

  Medicare reassignment NPD
• Christopher Ogbin, CRNA

  • Certified Registered Nurse Anesthetist
  • Townsend, DE
  • NPI 1629010806

  MD, Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• David E Levy, MD

  • Anesthesiology Physician
  • Annapolis, MD
  • NPI 1801821806
  Medicare reassignment
• Elizabeth Mary Mackey, CRNA

  • Certified Registered Nurse Anesthetist
  • Middle River, MD
  • NPI 1114622800
  Medicare reassignment
• Douglas Fenton Wiseman, MD

  • Anesthesiology Physician
  • Easton, MD
  • NPI 1912987355
  Medicare reassignment
• Kevin Oh, M.D.

  • Anesthesiology Physician
  • York, PA
  • NPI 1457333015

  MD

  Medicare reassignment
• Amavi E. Pitts, CRNA

  • Certified Registered Nurse Anesthetist
  • Wilmington, DE
  • NPI 1922238476

  MD

  Medicare reassignment

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

{
    "created_epoch": "1542067200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1680652800000",
    "number": "1114496759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2985",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627082985",
            "telephone_number": "941-360-1566",
            "fax_number": "941-358-9818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 E PULASKI HWY STE 2A",
            "city": "ELKTON",
            "state": "MD",
            "postal_code": "219216595",
            "telephone_number": "410-620-3348",
            "fax_number": "410-620-3351"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "APOLLO MEDICAL GROUP OF UPPER BAY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-11-13",
        "last_updated": "2023-04-05",
        "certification_date": "2023-04-05",
        "status": "A",
        "authorized_official_last_name": "VAN SPRUNDEL",
        "authorized_official_first_name": "ROBIN",
        "authorized_official_title_or_position": "DIRECTOR OF ADMINISTRATION",
        "authorized_official_telephone_number": "941-725-1198"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "367500000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Anesthesiology Physician in Elkton, MD
• Providers in Elkton, MD by specialty
• Anesthesiology Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 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.