NPIMap

Organization Active NPI

Surgical Anesthesia of Baton Rouge LLC

  • Anesthesiology Physician
  • Lake Charles, LA
National Provider Identifier
1316936974
Registry record updated Apr 5, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
SURGICAL ANESTHESIA OF BATON ROUGE LLC
Practice address
1757 Imperial Boulevard
Lake Charles, LA 70605-5362
Phone
(855) 706-5542
Fax
(706) 650-1034
NPI assigned
Oct 17, 2005
Last updated
Apr 5, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2016

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

Authorized official

Name
Mr. Andrew R. Ribaudo
Title
President
Phone
(404) 446-1417

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207L00000X Primary
Pain Medicine (Anesthesiology) PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207LP2900X

Addresses

Primary practice location

1757 Imperial Boulevard
Lake Charles, LA 70605-5362

Mailing address

PO Box #204298
Dallas, TX 75320-4298
Phone (855) 706-5542

Other identifiers 1

IdentifierTypeStateIssuer
1444413MedicaidLA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 38

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 38

NPI Registry JSON

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

{
    "created_epoch": "1129507200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1459814400000",
    "number": "1316936974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX #204298",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753204298",
            "telephone_number": "855-706-5542",
            "fax_number": "706-650-1034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1757 IMPERIAL BOULEVARD",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706055362",
            "telephone_number": "855-706-5542",
            "fax_number": "706-650-1034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SURGICAL ANESTHESIA OF BATON ROUGE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-17",
        "last_updated": "2016-04-05",
        "status": "A",
        "authorized_official_last_name": "RIBAUDO",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "404-446-1417",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1444413",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Charles, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2016; 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.