NPIMap

Organization Active NPI

Utb Anesthesia PLLC

  • Anesthesiology Physician
  • Tulsa, OK
National Provider Identifier
1407150709
Registry record updated Dec 29, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
UTB ANESTHESIA PLLC
Practice address
744 W 9TH St
Tulsa, OK 74127-9020
Phone
(918) 599-1000
NPI assigned
Dec 29, 2010
Last updated
Dec 29, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2010

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

Authorized official

Name
Mr. Stephen G Bovasso, D.O.
Title
President
Phone
(800) 232-5703

Specialties & licenses 1

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

Addresses

Primary practice location

744 W 9TH St
Tulsa, OK 74127-9020

Mailing address

PO Box 235019
Montgomery, AL 36123-5019
Phone (334) 279-1450

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110621000633 OK Part B Supplier - Clinic/Group Practice 0547448524 Receives reassigned benefits from 30 practitioners
Practice locations: Muskogee, OK; Tulsa, OK

National Provider Directory

National Provider Directory

Locations

744 W 9th St
Tulsa, OK 74127
Phone (918) 587-2561

9423 E 95th Ct
Tulsa, OK 74133
Phone (918) 496-2400

Practitioners & affiliated clinicians

Practitioners 30

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 30

NPI Registry JSON

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

{
    "created_epoch": "1293580800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1293580800000",
    "number": "1407150709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 235019",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361235019",
            "telephone_number": "334-279-1450",
            "fax_number": "334-395-4110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "744 W 9TH ST",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741279020",
            "telephone_number": "918-599-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UTB ANESTHESIA PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-29",
        "last_updated": "2010-12-29",
        "status": "A",
        "authorized_official_last_name": "BOVASSO",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "800-232-5703",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2010; 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.