NPIMap

Organization Active NPI

Summit Pain & Anesthesia Consultants

  • Anesthesiology Physician
  • Fort Worth, TX
National Provider Identifier
1508895301
Registry record updated Jul 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
SUMMIT PAIN & ANESTHESIA CONSULTANTS
Practice address
1000 Lipscomb St Ste 110
Fort Worth, TX 76104-3181
Phone
(817) 348-8600
NPI assigned
Jul 2, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2021

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

Authorized official

Name
Dr. Ved V Aggarwal, MDNPI 1669558136
Title
President
Phone
(817) 348-8600

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 Primary

Addresses

Primary practice location

1000 Lipscomb St Ste 110
Fort Worth, TX 76104-3181

Mailing address

11350 MC Cormick Rd Ep1 Ste 501
Hunt Valley, MD 21031

Other identifiers 2

IdentifierTypeStateIssuer
00C65TOtherTXBCBS
166830301MedicaidTX

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050309000756 TX Part B Supplier - Clinic/Group Practice 1951355239 Receives reassigned benefits from 5 practitioners
Practice locations: Fort Worth, TX; Keller, TX

National Provider Directory

National Provider Directory

Locations

1400 S Main St
Ste 406
Ft Worth, TX 76104

651 S Main St
Ste 1
Keller, TX 76248

Practitioners & affiliated clinicians

Practitioners 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1151798400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1626307200000",
    "number": "1508895301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11350 MC CORMICK RD EP1 STE 501",
            "city": "HUNT VALLEY",
            "state": "MD",
            "postal_code": "21031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 LIPSCOMB ST STE 110",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761043181",
            "telephone_number": "817-348-8600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMMIT PAIN & ANESTHESIA CONSULTANTS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-02",
        "last_updated": "2021-07-15",
        "certification_date": "2021-07-15",
        "status": "A",
        "authorized_official_last_name": "AGGARWAL",
        "authorized_official_first_name": "VED",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "817-348-8600",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "00C65T",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "166830301",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2021; 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.