Individual provider Active NPI

Joseph Cal Liljenquist, M.D.

  • Anesthesiology Physician
  • Savannah, GA
National Provider Identifier
1356600803
Registry record updated Nov 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
075483 Issued in GA
Practice address
4700 Waters Ave Dept of
Savannah, GA 31404-6220
Phone
(801) 529-6260
NPI assigned
May 3, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 27, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X R74032 AZ
Internal Medicine Physician 207R00000X 63212 NY
Anesthesiology Physician 207L00000X 075483 GA Primary

Addresses

Primary practice location

4700 Waters Ave Dept of
Savannah, GA 31404-6220

Mailing address

4700 Waters Ave Dept of
Savannah, GA 31404-6220
Phone (801) 529-6260

Other practice location 1

1501 N Campbell Ave
Dept. of Anesthesiology - Room 5301
Tucson, AZ 85724-0001
Phone (520) 626-7221

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160613000246 GA Practitioner - Anesthesiology 5496065229 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Albany Medical College of Union University, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sentry Anesthesia Management, LLCGroup PAC ID 9436372323, 170 clinicians
SE Georgia Anesthesia, LLCGroup PAC ID 8426466137, 114 clinicians

Practice addresses (Care Compare)

126 US Hwy 280 W
Americus, GA 31719-8645
Phone (229) 924-6011

4700 Waters Ave
(Memorial Health University Medical Center)
Savannah, GA 31404-6220
Phone (912) 350-8000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
R74032AZMDAnesthesiology Physician
63212NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
SE Georgia Anesthesia, LLC Anesthesiology CurrentSince Feb 10, 2024 Accepting new patients
Sentry Anesthesia Management, LLC Anesthesiology CurrentSince Nov 1, 2021 Accepting new patients
Anesthesia Consultants of Savannah, PC Anesthesiology CurrentSince Jul 1, 2016 Accepting new patients
University of Arizona Past Accepting new patients

Locations

126 US Highway 280 W
Americus, GA 31719
Phone (229) 924-6011

4700 Waters Ave
Savannah, GA 31404
Phone (912) 273-1100

1 Meadows Pkwy
Vidalia, GA 30474
Phone (912) 535-5429

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1336003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543276800000",
    "number": "1356600803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4700 WATERS AVE DEPT OF",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314046220",
            "telephone_number": "801-529-6260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4700 WATERS AVE DEPT OF",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314046220",
            "telephone_number": "801-529-6260"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1501 N Campbell Ave",
            "address_2": "Dept. of Anesthesiology - Room 5301",
            "address_purpose": "LOCATION",
            "city": "Tucson",
            "state": "AZ",
            "postal_code": "857240001",
            "country_code": "US",
            "telephone_number": "520-626-7221",
            "fax_number": "520-626-6943",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LILJENQUIST",
        "first_name": "JOSEPH",
        "middle_name": "CAL",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-05-03",
        "last_updated": "2018-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "AZ",
            "license": "R74032",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "63212",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "GA",
            "license": "075483",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Savannah, GA

Sources for this page

Verify at the official NPI Registry.