NPIMap

Organization Active NPI

Summit Anesthesia, LLC

  • Anesthesiology Physician
  • Fort Wayne, IN
National Provider Identifier
1649368085
Registry record updated Jan 8, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
SUMMIT ANESTHESIA, LLC
Practice address
700 Broadway
Fort Wayne, IN 46802-1402
Phone
(260) 969-1950
Fax
(260) 969-0989
NPI assigned
Oct 11, 2006
Last updated
Jan 8, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2010

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

Authorized official

Name
Muhammod A Ahmad, MDNPI 1992745806
Title
Group Manager
Phone
(317) 567-2180

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 Physician 207L00000X IN Primary

Addresses

Primary practice location

700 Broadway
Fort Wayne, IN 46802-1402

Mailing address

PO Box 11535
Fort Wayne, IN 46859-1535
Phone (317) 567-2180

Other identifiers 1

IdentifierTypeStateIssuer
200843170AMedicaidIN

National Provider Directory

National Provider Directory

Locations

11115 Parkview Plaza Dr
Fort Wayne, IN 46845
Phone (260) 266-5400

Practitioners & affiliated clinicians

Practitioners 20

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 20

NPI Registry JSON

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

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1262908800000",
    "number": "1649368085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11535",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468591535",
            "telephone_number": "317-567-2180",
            "fax_number": "317-567-2191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 BROADWAY",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468021402",
            "telephone_number": "260-969-1950",
            "fax_number": "260-969-0989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMMIT ANESTHESIA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-11",
        "last_updated": "2010-01-08",
        "status": "A",
        "authorized_official_last_name": "AHMAD",
        "authorized_official_first_name": "MUHAMMOD",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "GROUP MANAGER",
        "authorized_official_telephone_number": "317-567-2180",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200843170A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.