NPIMap

Organization Active NPI

Sunrise Anesthesia Services LLC

  • Anesthesiology Physician
  • Las Vegas, NV
National Provider Identifier
1124091160
Registry record updated Sep 24, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
2000656543 Issued in NV
Legal business name
SUNRISE ANESTHESIA SERVICES LLC
Practice address
3186 S Maryland Pkwy
Las Vegas, NV 89109
Phone
(702) 731-8099
Fax
(702) 731-8292
NPI assigned
Feb 9, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2007

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

Authorized official

Name
Jeff Rydberg
Title
Ceo
Phone
(702) 731-8099

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207L00000X 2000656543 NV Primary

Addresses

Primary practice location

3186 S Maryland Pkwy
Las Vegas, NV 89109

Mailing address

3196 S Maryland Pkwy
Suite 101
Las Vegas, NV 89109
Phone (702) 731-8099

Other identifiers 2

IdentifierTypeStateIssuer
XGG007670MedicaidCA
9570 95MedicaidAZ

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 6

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": "1139443200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1190592000000",
    "number": "1124091160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3196 S MARYLAND PKWY",
            "address_2": "SUITE 101",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "89109",
            "telephone_number": "702-731-8099",
            "fax_number": "702-731-8292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3186 S MARYLAND PKWY",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "89109",
            "telephone_number": "702-731-8099",
            "fax_number": "702-731-8292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUNRISE ANESTHESIA SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-09",
        "last_updated": "2007-09-24",
        "status": "A",
        "authorized_official_last_name": "RYDBERG",
        "authorized_official_first_name": "JEFF",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "702-731-8099"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology",
            "state": "NV",
            "license": "2000656543",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "XGG007670",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9570 95",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2007; 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.