NPIMap

Organization Active NPI

Buena Vista Anesthesia Medical Group

  • Anesthesiology Physician
  • Burbank, CA
National Provider Identifier
1366462293
Registry record updated Aug 5, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
BUENA VISTA ANESTHESIA MEDICAL GROUP
Practice address
501 S Buena Vista St
Burbank, CA 91505-4809
Phone
(818) 843-5111
Fax
(818) 847-3935
NPI assigned
Jul 21, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2013

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

Authorized official

Name
Paul Englund, M.D.
Title
General Partnership
Phone
(626) 696-1124

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207L00000X Primary
Pain Medicine (Anesthesiology) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207LP2900X
Interventional Pain Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208VP0014X

Addresses

Primary practice location

501 S Buena Vista St
Burbank, CA 91505-4809

Mailing address

PO Box 60790
Pasadena, CA 91116-6790
Phone (626) 696-1132

Other identifiers 2

IdentifierTypeStateIssuer
GR0084040MedicaidCA
ZZZ57658ZOtherCABLUE SHIELD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050107000780 CA Part B Supplier - Clinic/Group Practice 7113975996 Receives reassigned benefits from 98 practitioners
Practice locations: Burbank, CA; Valencia, CA; Mission Hills, CA; Glendale, CA; Encino, CA

National Provider Directory

National Provider Directory

Locations

27420 Tourney Rd
Valencia, CA 91355
Phone (661) 222-3100

Practitioners & affiliated clinicians

Practitioners 99

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 99

NPI Registry JSON

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

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1375660800000",
    "number": "1366462293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60790",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911166790",
            "telephone_number": "626-696-1132",
            "fax_number": "626-396-0851"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 S BUENA VISTA ST",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915054809",
            "telephone_number": "818-843-5111",
            "fax_number": "818-847-3935"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BUENA VISTA ANESTHESIA MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-21",
        "last_updated": "2013-08-05",
        "status": "A",
        "authorized_official_last_name": "ENGLUND",
        "authorized_official_first_name": "PAUL",
        "authorized_official_title_or_position": "GENERAL PARTNERSHIP",
        "authorized_official_telephone_number": "626-696-1124",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0084040",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "ZZZ57658Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Burbank, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2013; 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.