NPIMap

Organization Active NPI

Amsurg Melbourne Anesthesia LLC

  • Anesthesiology Physician
  • Melbourne, FL
National Provider Identifier
1477958189
Registry record updated Dec 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
AMSURG MELBOURNE ANESTHESIA LLC
Practice address
1401 S Apollo Blvd
Suite B
Melbourne, FL 32901-3179
Phone
(321) 725-5151
Fax
(615) 234-1720
NPI assigned
Oct 24, 2014
Last updated
Dec 12, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2024

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

Authorized official

Name
Mrs. Jean A. Kochendorfer
Title
Sr Director of RCM Transformation
Phone
(615) 263-4012

Specialties & licenses 1

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

Addresses

Primary practice location

1401 S Apollo Blvd
Suite B
Melbourne, FL 32901-3179

Mailing address

1A Burton Hills Blvd Ste 300
Nashville, TN 37215-6153
Phone (615) 240-3820

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150206000921 FL Part B Supplier - Clinic/Group Practice 3274858618 Receives reassigned benefits from 40 practitioners
Practice locations: Melbourne, FL

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

  • Melbourne ASC LP

    dba The Surgery Center of Melbourne

    • Certified Registered Nurse Anesthetist
    • Melbourne, FL
    • NPI 1487885182

    Member Of

    NPD member

Practitioners & affiliated clinicians

Practitioners 40

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 40

NPI Registry JSON

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

{
    "created_epoch": "1414108800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733961600000",
    "number": "1477958189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1A BURTON HILLS BLVD STE 300",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372156153",
            "telephone_number": "615-240-3820",
            "fax_number": "615-234-1720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 S APOLLO BLVD",
            "address_2": "SUITE B",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329013179",
            "telephone_number": "321-725-5151",
            "fax_number": "615-234-1720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMSURG MELBOURNE ANESTHESIA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-24",
        "last_updated": "2024-12-12",
        "certification_date": "2024-12-12",
        "status": "A",
        "authorized_official_last_name": "KOCHENDORFER",
        "authorized_official_first_name": "JEAN",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "SR DIRECTOR OF RCM TRANSFORMATION",
        "authorized_official_telephone_number": "615-263-4012",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Melbourne, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2024; 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.