NPIMap

Organization Active NPI

Keystone Anesthesia, LLC

  • Certified Registered Nurse Anesthetist
  • Seneca, PA
National Provider Identifier
1477536779
Registry record updated Jul 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
Legal business name
KEYSTONE ANESTHESIA, LLC
Practice address
3744 State Route 257
Seneca, PA 16346-3318
Phone
(814) 677-6638
Fax
(814) 676-1593
NPI assigned
Nov 22, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 5, 2019

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

Authorized official

Name
Dr. Daviid A Femovich, MD
Title
Member
Phone
(814) 677-6700

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse AnesthetistGroup: 193400000X SINGLE SPECIALTY GROUP 367500000X Primary

Addresses

Primary practice location

3744 State Route 257
Seneca, PA 16346-3318

Mailing address

3744 State Route 257
Seneca, PA 16346-3318
Phone (814) 677-6700

Other identifiers 1

IdentifierTypeStateIssuer
580913OtherPABLUE SHIELD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041229000985 PA Part B Supplier - Clinic/Group Practice 9335130053 Receives reassigned benefits from 13 practitioners
Practice locations: Seneca, PA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1132617600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1562284800000",
    "number": "1477536779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3744 STATE ROUTE 257",
            "city": "SENECA",
            "state": "PA",
            "postal_code": "163463318",
            "telephone_number": "814-677-6700",
            "fax_number": "814-677-6776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3744 STATE ROUTE 257",
            "city": "SENECA",
            "state": "PA",
            "postal_code": "163463318",
            "telephone_number": "814-677-6638",
            "fax_number": "814-676-1593"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEYSTONE ANESTHESIA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-22",
        "last_updated": "2019-07-05",
        "status": "A",
        "authorized_official_last_name": "FEMOVICH",
        "authorized_official_first_name": "DAVIID",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "814-677-6700",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "580913",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Seneca, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2019; 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.