Organization Active NPI

Jeffrey Senasu PLLC

  • Anesthesiology Physician
  • Bettendorf, IA
National Provider Identifier
1447665252
Registry record updated Jul 1, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
036130261 Issued in IL
Legal business name
JEFFREY SENASU PLLC
Practice address
4500 Utica Ridge Rd
Bettendorf, IA 52722-1626
Phone
(563) 742-5000
NPI assigned
Jul 1, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2014

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

Authorized official

Name
Jeffrey Senasu, M.D.NPI 1962718007
Title
Owner
Phone
(219) 309-3169

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: 193400000X SINGLE SPECIALTY GROUP 207L00000X 036130261 IL Primary

Addresses

Primary practice location

4500 Utica Ridge Rd
Bettendorf, IA 52722-1626

Mailing address

3713 53Rd Ave
Bettendorf, IA 52722-1191
Phone (219) 309-3169

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA, IL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20140815001753 IA Part B Supplier - Clinic/Group Practice 2466679386 Receives reassigned benefits from 1 practitioner
Practice locations: Davenport, IA
O20140917001642 IL Part B Supplier - Clinic/Group Practice 2466679386 Receives reassigned benefits from 1 practitioner
Practice locations: Moline, IL; Silvis, IL

National Provider Directory

National Provider Directory

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": "1404172800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1404172800000",
    "number": "1447665252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3713 53RD AVE",
            "city": "BETTENDORF",
            "state": "IA",
            "postal_code": "527221191",
            "telephone_number": "219-309-3169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 UTICA RIDGE RD",
            "city": "BETTENDORF",
            "state": "IA",
            "postal_code": "527221626",
            "telephone_number": "563-742-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEFFREY SENASU PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-01",
        "last_updated": "2014-07-01",
        "status": "A",
        "authorized_official_last_name": "SENASU",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "219-309-3169",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology",
            "state": "IL",
            "license": "036130261",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bettendorf, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2014; 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.