NPIMap

Organization Active NPI

Twin Cities Anesthesia Associates, PL

  • Anesthesiology Physician
  • Niceville, FL
National Provider Identifier
1497199731
Registry record updated Jun 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
ME69348 Issued in FL
Legal business name
TWIN CITIES ANESTHESIA ASSOCIATES, PL
Practice address
2190 Highway 85 N
Niceville, FL 32578-1045
Phone
(850) 678-4131
Fax
(850) 729-9342
NPI assigned
Apr 17, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2013

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

Authorized official

Name
Dr. Arthur P Broaderick, M.D.NPI 1922104678
Title
President
Phone
(850) 803-2297

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 ME69348 FL Primary

Addresses

Primary practice location

2190 Highway 85 N
Niceville, FL 32578-1045

Mailing address

PO Box 7419
Orlando, FL 32891-7419
Phone (866) 619-4860

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130620000186 FL Part B Supplier - Clinic/Group Practice 5092954222 Receives reassigned benefits from 8 practitioners
Practice locations: Niceville, FL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 8

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": "1366156800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1371513600000",
    "number": "1497199731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7419",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328917419",
            "telephone_number": "866-619-4860",
            "fax_number": "866-665-2702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2190 HIGHWAY 85 N",
            "city": "NICEVILLE",
            "state": "FL",
            "postal_code": "325781045",
            "telephone_number": "850-678-4131",
            "fax_number": "850-729-9342"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TWIN CITIES ANESTHESIA ASSOCIATES, PL",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-17",
        "last_updated": "2013-06-18",
        "status": "A",
        "authorized_official_last_name": "BROADERICK",
        "authorized_official_first_name": "ARTHUR",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "850-803-2297",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology",
            "state": "FL",
            "license": "ME69348",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Niceville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2013; 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.