NPIMap

Organization Active NPI

Holy Cross Anesthesiology Associate PA

  • Anesthesiology Physician
  • Burtonsville, MD
National Provider Identifier
1376501007
Registry record updated Nov 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
HOLY CROSS ANESTHESIOLOGY ASSOCIATE PA
Practice address
4000 Blackburn LN Ste 220
Burtonsville, MD 20866-1104
Phone
(301) 770-8700
NPI assigned
May 3, 2006
Last updated
Nov 27, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2024

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

Authorized official

Name
Sara Depew, MDNPI 1659506244
Title
President
Phone
(347) 731-2133

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
Anesthesiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207L00000X Primary

Addresses

Primary practice location

4000 Blackburn LN Ste 220
Burtonsville, MD 20866-1104

Mailing address

PO Box 64605
Baltimore, MD 21264
Phone (301) 933-8554

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, MD2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040322001776 DC Part B Supplier - Clinic/Group Practice 3577454313 Receives reassigned benefits from 84 practitioners
Practice locations: Rockville, MD; Sliver Springs, MD; Silver Spring, MD; Rokville, MD; Rockhill, MD; Lanham, MD; Germantown, MD; Chevy Chase, MD…
O20230117002743 MD Part B Supplier - Clinic/Group Practice 3577454313 Receives reassigned benefits from 42 practitioners
1 other NPI on this enrollment
Practice locations: Annapolis, MD; Columbia, MD; Frederick, MD; Fulton, MD; Gaithersburg, MD

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Holy Cross Anest Assoc PA18 organizations share this tax ID, including this one

Other organizations with this tax ID 17

Organizations that report the same tax identification number in the National Provider Directory.

View all 17

Locations

810 Bestgate Rd
Ste 120
Annapolis, MD 21401

4000 Blackburn Ln
Burtonsville, MD 20866
Phone (301) 421-4241

4000 Blackburn Ln
Ste 220
Burtonsville, MD 20866
Phone (262) 888-8186

6301 Executive Blvd
Rockville, MD 20852
Phone (301) 770-4967

1400 Forest Glen Rd
Ste 500
Silver Spring, MD 20910
Phone (301) 453-5970

Ownership & related parties

Subparts reporting this organization as parent 17

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

View all 17

Practitioners & affiliated clinicians

Practitioners 87

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 87

NPI Registry JSON

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

{
    "created_epoch": "1146614400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1732665600000",
    "number": "1376501007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 64605",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "21264",
            "telephone_number": "301-933-8554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 BLACKBURN LN STE 220",
            "city": "BURTONSVILLE",
            "state": "MD",
            "postal_code": "208661104",
            "telephone_number": "301-770-8700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOLY CROSS ANESTHESIOLOGY ASSOCIATE PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-03",
        "last_updated": "2024-11-27",
        "certification_date": "2024-11-27",
        "status": "A",
        "authorized_official_last_name": "DEPEW",
        "authorized_official_first_name": "SARA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "347-731-2133",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burtonsville, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2024; 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.