NPIMap

Organization Active NPI

Anesthesiology of Marquette, P.C.

  • Anesthesiology Physician
  • Marquette, MI
National Provider Identifier
1225039639
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
ANESTHESIOLOGY OF MARQUETTE, P.C.
Practice address
580 W College Ave
Marquette, MI 49855-2705
Phone
(906) 226-2569
NPI assigned
Aug 9, 2005
Last updated
Jul 21, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Dr. Prakash Dhadphale, M.D.NPI 1043211188
Title
President
Phone
(906) 226-2569

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
Anesthesiology Physician 207L00000X MI Primary

Addresses

Primary practice location

580 W College Ave
Marquette, MI 49855-2705

Mailing address

710 Chippewa Square
Suite 103
Marquette, MI 49855
Phone (906) 226-2569

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20051003000636 MI Part B Supplier - Clinic/Group Practice 6103851712 Receives reassigned benefits from 43 practitioners
Practice locations: Marquette, MI

National Provider Directory

National Provider Directory

Locations

710 Chippewa Sq
Marquette, MI 49855
Phone (906) 226-2569

710 Chippewa Sq
Ste 103
Marquette, MI 49855
Phone (906) 226-2569

Practitioners & affiliated clinicians

Practitioners 46

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 46

NPI Registry JSON

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

{
    "created_epoch": "1123545600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1225039639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "710 CHIPPEWA SQUARE",
            "address_2": "SUITE 103",
            "city": "MARQUETTE",
            "state": "MI",
            "postal_code": "49855",
            "telephone_number": "906-226-2569",
            "fax_number": "906-226-3225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "580 W COLLEGE AVE",
            "city": "MARQUETTE",
            "state": "MI",
            "postal_code": "498552705",
            "telephone_number": "906-226-2569"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANESTHESIOLOGY OF MARQUETTE, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-09",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "DHADPHALE",
        "authorized_official_first_name": "PRAKASH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "906-226-2569",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marquette, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.