NPIMap

Organization Active NPI

Midwest Anesthesia P.C.

  • Interventional Pain Medicine Physician
  • Fremont, NE
National Provider Identifier
1316011315
Registry record updated Jun 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X
License
21157 Issued in NE
Legal business name
MIDWEST ANESTHESIA P.C.
Practice address
2900 Elk LN
Fremont, NE 68025
Phone
(402) 721-8895
Fax
(402) 721-6663
NPI assigned
Nov 20, 2006
Last updated
Jun 27, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2023

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

Authorized official

Name
Soubrata V Raikar, M.D.NPI 1154495125
Title
Owner
Phone
(402) 721-8895

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Anesthesiology Physician 207L00000X 21157 NE
Interventional Pain Medicine Physician 208VP0014X 21157 NE Primary

Addresses

Primary practice location

2900 Elk LN
Fremont, NE 68025

Mailing address

2900 Elk LN
Fremont, NE 68025-8691
Phone (402) 721-8895

Other practice location 1

8814 Maple St Ste 1
Omaha, NE 68134-6126
Phone (402) 620-6650

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040818001305 NE Part B Supplier - Clinic/Group Practice 9739152596 Receives reassigned benefits from 10 practitioners
Practice locations: Fremont, NE; Omaha, NE
O20120118000270 NE DME Supplier - Physician - Unknown Physician Specialty 9739152596 Practice locations: Fremont, NE

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
28D2173488Midwest Anesthesia PC2900 Elk Lane Suite 1, Fremont, NE 68025AccreditationMar 3, 2028

National Provider Directory

National Provider Directory

Locations

2900 E Elk Ln
Fremont, NE 68025
Phone (402) 721-8895

8814 Maple St
Ste 1
Omaha, NE 68134
Phone (402) 620-6650

9015 Arbor St
Omaha, NE 68124
Phone (402) 384-2600

Practitioners & affiliated clinicians

Practitioners 12

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": "1163980800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1687824000000",
    "number": "1316011315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2900 ELK LN",
            "city": "FREMONT",
            "state": "NE",
            "postal_code": "680258691",
            "telephone_number": "402-721-8895",
            "fax_number": "402-721-6663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 ELK LN",
            "city": "FREMONT",
            "state": "NE",
            "postal_code": "68025",
            "telephone_number": "402-721-8895",
            "fax_number": "402-721-6663"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8814 Maple St Ste 1",
            "address_purpose": "LOCATION",
            "city": "Omaha",
            "state": "NE",
            "postal_code": "681346126",
            "country_code": "US",
            "telephone_number": "402-620-6650",
            "fax_number": "402-620-6651",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MIDWEST ANESTHESIA P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-20",
        "last_updated": "2023-06-27",
        "certification_date": "2023-06-27",
        "status": "A",
        "authorized_official_last_name": "RAIKAR",
        "authorized_official_first_name": "SOUBRATA",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "402-721-8895",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NE",
            "license": "21157",
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "NE",
            "license": "21157",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fremont, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.