NPIMap

Organization Active NPI

Gulf-to-Bay Anesthesiology Associates LLC

  • Pain Medicine (Anesthesiology) Physician
  • Lutz, FL
National Provider Identifier
1225365489
Registry record updated Apr 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
Legal business name
GULF-TO-BAY ANESTHESIOLOGY ASSOCIATES LLC
Practice address
4961 Van Dyke Rd
Lutz, FL 33558-4813
Phone
(813) 253-2273
Fax
(813) 253-2279
NPI assigned
Nov 9, 2009
Last updated
Apr 27, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2012

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

Authorized official

Name
Devanand Mangar, MDNPI 1215980958
Title
Ceo/President
Phone
(813) 844-4434

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Anesthesiology) Physician 207LP2900X NU Primary
Pain Medicine Physician 208VP0000X NU
Interventional Pain Medicine Physician 208VP0014X NU

Addresses

Primary practice location

4961 Van Dyke Rd
Lutz, FL 33558-4813

Mailing address

809 S Albany Ave
Tampa, FL 33606-2407
Phone (813) 844-4396

Other names 1

  • GTBA Pain Van Dyke Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031106000250 FL Part B Supplier - Clinic/Group Practice 5092628156 Receives reassigned benefits from 1,280 practitioners
16 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Tampa, FL; Trinity, FL; Temple Terrace, FL; Riverview, FL; Palatka, FL; Odessa, FL; Largo, FL; Lakeland, FL…

Other NPIs on the same Medicare enrollment 16

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

View all 16

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1257724800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1335484800000",
    "number": "1225365489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "809 S ALBANY AVE",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336062407",
            "telephone_number": "813-844-4396",
            "fax_number": "813-844-4972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4961 VAN DYKE RD",
            "city": "LUTZ",
            "state": "FL",
            "postal_code": "335584813",
            "telephone_number": "813-253-2273",
            "fax_number": "813-253-2279"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GULF-TO-BAY ANESTHESIOLOGY ASSOCIATES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-11-09",
        "last_updated": "2012-04-27",
        "status": "A",
        "authorized_official_last_name": "MANGAR",
        "authorized_official_first_name": "DEVANAND",
        "authorized_official_title_or_position": "CEO/PRESIDENT",
        "authorized_official_telephone_number": "813-844-4434",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GTBA Pain Van Dyke",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Lutz, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2012; 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.