NPIMap

Organization Active NPI

Riverside Anesthesia Services, LLC

  • Certified Registered Nurse Anesthetist
  • Jacksonville, FL
National Provider Identifier
1134478209
Registry record updated May 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
Legal business name
RIVERSIDE ANESTHESIA SERVICES, LLC
Practice address
7207 Golden Wings Rd
Ste 200
Jacksonville, FL 32244-3313
Phone
(904) 389-1010
Fax
(904) 771-2191
NPI assigned
Sep 5, 2012
Last updated
May 25, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 25, 2021

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

Authorized official

Name
Ronak A Patel, DONPI 1558420893
Title
Medical Director
Phone
(904) 389-1010

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X NU
Certified Registered Nurse Anesthetist 367500000X NU Primary

Addresses

Primary practice location

7207 Golden Wings Rd
Ste 200
Jacksonville, FL 32244-3313

Mailing address

PO Box 864848
Orlando, FL 32886-4848
Phone (239) 610-0775

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20121026000522 FL Part B Supplier - Clinic/Group Practice 4688824600 Receives reassigned benefits from 45 practitioners
Practice locations: Jacksonville, FL

National Provider Directory

National Provider Directory

Member of 1

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

Locations

2386 Dunn Ave
Jacksonville, FL 32218

7207 Golden Wings Rd
Jacksonville, FL 32244

7207 Golden Wings Rd
Ste 200
Jacksonville, FL 32244
Phone (904) 389-1014

Practitioners & affiliated clinicians

Practitioners 50

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.

View all 50

NPI Registry JSON

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

{
    "created_epoch": "1346803200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1621900800000",
    "number": "1134478209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 864848",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328864848",
            "telephone_number": "239-610-0775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7207 GOLDEN WINGS RD",
            "address_2": "STE 200",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322443313",
            "telephone_number": "904-389-1010",
            "fax_number": "904-771-2191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIVERSIDE ANESTHESIA SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-05",
        "last_updated": "2021-05-25",
        "certification_date": "2021-05-25",
        "status": "A",
        "authorized_official_last_name": "PATEL",
        "authorized_official_first_name": "RONAK",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "904-389-1010",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2021; 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.