Individual provider Active NPI

Stanley M Aung, MD

  • Pain Medicine (Anesthesiology) Physician
  • Bloomington, IL
National Provider Identifier
1437135456
Registry record updated Jan 10, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
License
036085651 Issued in IL
Practice address
1505 Eastland Dr
LL 1400
Bloomington, IL 61701-3534
Phone
(309) 663-4700
Fax
(309) 665-0575
NPI assigned
Dec 21, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X G148288 CA
Pain Medicine (Anesthesiology) Physician 207LP2900X 036085651 IL Primary

Addresses

Primary practice location

1505 Eastland Dr
LL 1400
Bloomington, IL 61701-3534

Mailing address

1505 Eastland Dr
LL 1400
Bloomington, IL 61701-3534
Phone (309) 663-4700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20180209001797 CA Practitioner - Anesthesiology 9335043231 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cep America - Anesthesia PCGroup PAC ID 3678897915, 849 clinicians

Practice addresses (Care Compare)

975 S Fairmont Ave
Lodi, CA 95240-5118
Phone (209) 334-3411

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G148288CAMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America - Anesthesia PC Anesthesiology CurrentSince Jan 9, 2018 Accepting new patients
Cep America - Anesthesia PC Anesthesiology CurrentSince Jan 9, 2018 Accepting new patients
Cep America - Anesthesia, PC Anesthesiology Current Accepting new patients

Locations

2100 Powell St
Ste 900
Emeryville, CA 94608
Phone (510) 350-2777

975 S Fairmont Ave
Lodi, CA 95240
Phone (209) 339-7575

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

Organizations & group practices 3

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 1

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": "1135123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1515542400000",
    "number": "1437135456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1505 EASTLAND DR",
            "address_2": "LL 1400",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617013534",
            "telephone_number": "309-663-4700",
            "fax_number": "309-665-0575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1505 EASTLAND DR",
            "address_2": "LL 1400",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617013534",
            "telephone_number": "309-663-4700",
            "fax_number": "309-665-0575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AUNG",
        "first_name": "STANLEY",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-21",
        "last_updated": "2018-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "G148288",
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "IL",
            "license": "036085651",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomington, IL

Sources for this page

Verify at the official NPI Registry.