Organization Active NPI

GMS Anesthesia Associates, P.C.

  • Contractor
  • Hackensack, NJ
National Provider Identifier
1417075060
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ContractorTaxonomy code 171W00000X
Legal business name
GMS ANESTHESIA ASSOCIATES, P.C.
Practice address
100 Prospect Ave
#4F
Hackensack, NJ 07601-1910
Phone
(201) 487-8557
Fax
(201) 487-6414
NPI assigned
Mar 26, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Prof. Kathy V Podesta
Title
Office Manager
Phone
(201) 487-8557

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ContractorGroup: 193400000X SINGLE SPECIALTY GROUP 171W00000X Primary

Addresses

Primary practice location

100 Prospect Ave
#4F
Hackensack, NJ 07601-1910

Mailing address

PO Box 1944
South Hackensack, NJ 07606-0544
Phone (201) 487-8557

Other identifiers 3

IdentifierTypeStateIssuer
0148504MedicaidNJ
8468206MedicaidNJ
5658004MedicaidNJ

National Provider Directory

National Provider Directory

Locations

10561 Barkley St
Ste 300
Overland Park, KS 66212

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1174867200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1417075060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1944",
            "city": "SOUTH HACKENSACK",
            "state": "NJ",
            "postal_code": "076060544",
            "telephone_number": "201-487-8557",
            "fax_number": "201-487-6414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 PROSPECT AVE",
            "address_2": "#4F",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076011910",
            "telephone_number": "201-487-8557",
            "fax_number": "201-487-6414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GMS ANESTHESIA ASSOCIATES, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-26",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PODESTA",
        "authorized_official_first_name": "KATHY",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "201-487-8557",
        "authorized_official_name_prefix": "Prof."
    },
    "taxonomies": [
        {
            "code": "171W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Contractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0148504",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8468206",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5658004",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hackensack, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.