NPIMap

Organization Active NPI

Ambulatory Surgery Anesthesia LLC

  • Certified Registered Nurse Anesthetist
  • Lawrenceville, GA
National Provider Identifier
1336328293
Registry record updated Oct 30, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
Legal business name
AMBULATORY SURGERY ANESTHESIA LLC
Practice address
475 Philip Blvd
Suite 304
Lawrenceville, GA 30045-8737
Phone
(678) 377-8252
NPI assigned
Oct 29, 2007
Last updated
Oct 30, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2007

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

Authorized official

Name
Dr. Bhuvanendram Indrakrishnan, MDNPI 1598847618
Title
Sole Member
Phone
(678) 377-8252

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
Certified Registered Nurse AnesthetistGroup: 193400000X SINGLE SPECIALTY GROUP 367500000X Primary

Addresses

Primary practice location

475 Philip Blvd
Suite 304
Lawrenceville, GA 30045-8737

Mailing address

PO Box 8846
Greensboro, NC 27419-0846
Phone (336) 553-1659

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080107000599 GA Part B Supplier - Clinic/Group Practice 8426138256 Receives reassigned benefits from 6 practitioners
Practice locations: Lawrenceville, GA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 7

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": "1193616000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193702400000",
    "number": "1336328293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8846",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274190846",
            "telephone_number": "336-553-1659",
            "fax_number": "336-553-3994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "475 PHILIP BLVD",
            "address_2": "SUITE 304",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300458737",
            "telephone_number": "678-377-8252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMBULATORY SURGERY ANESTHESIA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-29",
        "last_updated": "2007-10-30",
        "status": "A",
        "authorized_official_last_name": "INDRAKRISHNAN",
        "authorized_official_first_name": "BHUVANENDRAM",
        "authorized_official_title_or_position": "SOLE MEMBER",
        "authorized_official_telephone_number": "678-377-8252",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrenceville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2007; 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.