NPIMap

Organization Active NPI

Prime Anesthesia Services

  • Certified Registered Nurse Anesthetist
  • Metairie, LA
National Provider Identifier
1124707435
Registry record updated Jul 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
Legal business name
PRIME ANESTHESIA SERVICES
Practice address
3636 S I 10 Service Rd W Ste 204
Metairie, LA 70001-6418
Phone
(985) 707-3343
NPI assigned
Jul 13, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2023

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

Authorized official

Name
Lance Morello, CRNANPI 1053831289
Title
Authorized Official
Phone
(985) 707-3343

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse AnesthetistGroup: 193400000X SINGLE SPECIALTY GROUP 367500000X Primary

Addresses

Primary practice location

3636 S I 10 Service Rd W Ste 204
Metairie, LA 70001-6418

Mailing address

PO Box 70
Lake Forest, IL 60045-0070
Phone (800) 444-6110

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20231130000504 LA Part B Supplier - Clinic/Group Practice 2567810658 Receives reassigned benefits from 41 practitioners
Practice locations: Hammond, LA; Metairie, LA; Mandeville, LA

National Provider Directory

National Provider Directory

Locations

4715 S I 10 Service Rd W
Metairie, LA 70001
Phone (504) 228-8356

Practitioners & affiliated clinicians

Practitioners 41

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 41

NPI Registry JSON

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

{
    "created_epoch": "1689206400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1689206400000",
    "number": "1124707435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 70",
            "city": "LAKE FOREST",
            "state": "IL",
            "postal_code": "600450070",
            "telephone_number": "800-444-6110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3636 S I 10 SERVICE RD W STE 204",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "700016418",
            "telephone_number": "985-707-3343"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIME ANESTHESIA SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-07-13",
        "last_updated": "2023-07-13",
        "certification_date": "2023-07-13",
        "status": "A",
        "authorized_official_last_name": "MORELLO",
        "authorized_official_first_name": "LANCE",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "985-707-3343",
        "authorized_official_credential": "CRNA"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Metairie, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 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.