Beachside Anesthesia Inc

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

Legal business name

BEACHSIDE ANESTHESIA INC

Practice address

95 Bulldog Blvd
Melbourne, FL 32901-3332

Phone

(321) 729-9493

NPI assigned

Jan 2, 2018

Last updated

Jan 2, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mary Margaret Boger, CRNANPI 1508952961

Title

President

Phone

(321) 783-8926

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

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.

• Mary M Boger, CRNA

  • Certified Registered Nurse Anesthetist
  • Melbourne, FL
  • NPI 1508952961
  Authorized official Same address or phone

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

{
    "created_epoch": "1514851200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1514851200000",
    "number": "1164939971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 320281",
            "city": "COCOA BEACH",
            "state": "FL",
            "postal_code": "329320281",
            "telephone_number": "573-686-5550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "95 BULLDOG BLVD",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329013332",
            "telephone_number": "321-729-9493"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEACHSIDE ANESTHESIA INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-02",
        "last_updated": "2018-01-02",
        "status": "A",
        "authorized_official_last_name": "BOGER",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "MARGARET",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "321-783-8926",
        "authorized_official_credential": "CRNA"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE DEPT HEALTH",
            "identifier": "ARNP9164912",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bayside Therapy
• Baytree Behavioral Health PA
• Baytree Medical Associates LLC (Baytree Medical Associates)
• Baytree Medical Group LLC
• BCG Dental Group, P LLC
• Beachside Dermatology, LLC
• Beachside Physical Therapy Inc
• Beachside Physical Therapy, Inc
• Barbara A Beadle, PHARMD
• Mercedes Alejandra Beadnell

• Anesthesiology Physician in Melbourne, FL
• Providers in Melbourne, FL by specialty
• Anesthesiology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2018; 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.