Individual provider Active NPI

Manuel A. Bermudez, AA-C

  • Anesthesiologist Assistant
  • Tallahassee, FL
National Provider Identifier
1609159516
Registry record updated Sep 27, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiologist AssistantTaxonomy code 367H00000X
License
AA104 Issued in FL
Practice address
2173 Centerville PL Ste a
Tallahassee, FL 32308-8303
Phone
(850) 385-0144
NPI assigned
Sep 27, 2011
Last updated
Sep 27, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiologist Assistant 367H00000X AA104 FL Primary

Addresses

Primary practice location

2173 Centerville PL Ste a
Tallahassee, FL 32308-8303

Mailing address

PO Box 452198
Sunrise, FL 33345-2198
Phone (954) 838-2371

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111118000339 FL Practitioner - Anesthesiology Assistant 8123292620 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology Assistant
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1300 Miccosukee Rd
Tallahassee, FL 32308-5054
Phone (954) 939-5000

2629 Welaunee Blvd
Tallahassee, FL 32308-4697
Phone (954) 939-5000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
AA104FLMDAnesthesiologist Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesiology Associates of Tallahassee Inc CurrentSince Oct 26, 2011 Accepting new patients
Anesthesiology Associates of Tallahassee Inc CurrentSince Oct 26, 2011 Accepting new patients
Anesthesiology Associates of Tallahassee Inc Past Accepting new patients

Locations

333 N Byron Butler Pkwy
Perry, FL 32347
Phone (850) 584-0643

1300 Miccosukee Rd
Tallahassee, FL 32308
Phone (850) 431-1155

1608 Surgeons Dr
Tallahassee, FL 32308
Phone (850) 431-6200

2173 Centerville Pl
Ste A
Tallahassee, FL 32308

2626 Capital Medical Blvd
Tallahassee, FL 32308
Phone (850) 325-5000

2629 Welaunee Blvd
Tallahassee, FL 32308
Phone (850) 877-4688

3334 Capital Medical Blvd
Ste 500
Tallahassee, FL 32308
Phone (850) 877-4688

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1317081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317081600000",
    "number": "1609159516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 452198",
            "city": "SUNRISE",
            "state": "FL",
            "postal_code": "333452198",
            "telephone_number": "954-838-2371",
            "fax_number": "954-851-1746"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2173 CENTERVILLE PL STE A",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323088303",
            "telephone_number": "850-385-0144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERMUDEZ",
        "first_name": "MANUEL",
        "middle_name": "A.",
        "credential": "AA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-09-27",
        "last_updated": "2011-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367H00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiologist Assistant",
            "state": "FL",
            "license": "AA104",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tallahassee, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.