NPIMap

Organization Active NPI

Blue Cloud Anesthesia, LLC

  • Anesthesiology Physician
  • Fort Myers, FL
National Provider Identifier
1124721816
Registry record updated Jan 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
BLUE CLOUD ANESTHESIA, LLC
Practice address
3700 Central Ave Ste 2
Fort Myers, FL 33901-7649
Phone
(239) 387-1587
NPI assigned
Mar 23, 2023
Last updated
Jan 27, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2025

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

Authorized official

Name
Devin Larsen
Title
Ceo
Phone
(208) 340-1840

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X NU Primary

Addresses

Primary practice location

3700 Central Ave Ste 2
Fort Myers, FL 33901-7649

Mailing address

9709 Lakeside Blvd Ste 350
Spring, TX 77381-1213
Phone (713) 489-2198

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250903004278 FL Part B Supplier - Clinic/Group Practice 0840792420 Receives reassigned benefits from 19 practitioners
3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Jacksonville, FL; Miami, FL; Oakland Park, FL; Orlando, FL; Palm Springs, FL; Pensacola, FL; Tampa, FL; Fort Myers, FL

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Blue Cloud Anesthesia LLC6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1679529600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1737936000000",
    "number": "1124721816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9709 LAKESIDE BLVD STE 350",
            "city": "SPRING",
            "state": "TX",
            "postal_code": "773811213",
            "telephone_number": "713-489-2198",
            "fax_number": "713-489-2978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3700 CENTRAL AVE STE 2",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339017649",
            "telephone_number": "239-387-1587"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE CLOUD ANESTHESIA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-23",
        "last_updated": "2025-01-27",
        "certification_date": "2025-01-27",
        "status": "A",
        "authorized_official_last_name": "LARSEN",
        "authorized_official_first_name": "DEVIN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "208-340-1840"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2025; 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.