Active NPI
Ba Ventures LLC
- Anesthesiology Physician
- Roseburg, OR
National Provider Identifier
1154093847
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- Legal business name
- BA VENTURES LLC
- Practice address
- 2435 NW Kline St
Roseburg, OR 97471-1687 - Phone
- (541) 673-8182
- Fax
- (541) 673-9083
- NPI assigned
- Sep 30, 2021
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Bala Ambati, MD
- Title
- Medical Director
- Phone
- (541) 343-5000
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | Primary |
Addresses
Primary practice location
2435 NW Kline St
Roseburg, OR 97471-1687
Mailing address
2435 NW Kline St
Roseburg, OR 97471-1687
Phone (541) 343-5000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OR
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20231011003412 | OR | Part B Supplier - Clinic/Group Practice | 2264890847 |
Receives reassigned benefits from 8 practitioners Practice locations: Eugene, OR; Roseburg, OR |
National Provider Directory
National Provider DirectoryMember organizations 1
Organizations listed as members of this organization in the National Provider Directory.
-
- Ambulatory Surgical Clinic/Center
- Roseburg, OR
- NPI 1053353359
Member Of
Locations
489 W South Jordan Pkwy
Ste 300
South Jordan, UT 84095
Phone (385) 222-2020
Practitioners & affiliated clinicians
Practitioners 9
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Certified Registered Nurse Anesthetist
- Jacksonville, OR
- NPI 1346649993
OR
-
- Ophthalmology Physician
- Eugene, OR
- NPI 1750397576
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1632960000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1689120000000",
"number": "1154093847",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2435 NW KLINE ST",
"city": "ROSEBURG",
"state": "OR",
"postal_code": "974711687",
"telephone_number": "541-343-5000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2435 NW KLINE ST",
"city": "ROSEBURG",
"state": "OR",
"postal_code": "974711687",
"telephone_number": "541-673-8182",
"fax_number": "541-673-9083"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "BA VENTURES LLC",
"organizational_subpart": "NO",
"enumeration_date": "2021-09-30",
"last_updated": "2023-07-12",
"certification_date": "2023-07-12",
"status": "A",
"authorized_official_last_name": "AMBATI",
"authorized_official_first_name": "BALA",
"authorized_official_title_or_position": "MEDICAL DIRECTOR",
"authorized_official_telephone_number": "541-343-5000",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Anesthesiology",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Roseburg, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 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.