Individual provider Active NPI

Ganiyu T. Amusa, M.D.

  • Anesthesiology Physician
  • Paoli, PA
National Provider Identifier
1649537788
Registry record updated Jan 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
MD475604 Issued in PA
Practice address
255 W Lancaster Ave
Paoli, PA 19301-1763
Phone
(484) 565-1000
NPI assigned
Apr 13, 2012
Last updated
Jan 11, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Anesthesiology Physician 207L00000X 25MA10047300 NJ
Anesthesiology Physician 207L00000X MD475604 PA Primary

Addresses

Primary practice location

255 W Lancaster Ave
Paoli, PA 19301-1763

Mailing address

610 W Germantown Pike Ste 150
Plymouth Meeting, PA 19462-1062
Phone (610) 525-4966

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, PA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20170815000248 NJ Practitioner - AnesthesiologyPractitioner - Pain Management 3476848474 Reassigns benefits to 1 organization
I20230628002982 PA Practitioner - Anesthesiology 3476848474 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
United Anesthesia Services PCGroup PAC ID 3173437613, 437 clinicians

Practice addresses (Care Compare)

130 S Bryn Mawr Ave
Bryn Mawr, PA 19010-3121
Phone (610) 526-3000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
United Anesthesia Services PC Anesthesiology CurrentSince Jun 15, 2023 Accepting new patients
Morris Anesthesia Group, PA Anesthesiology CurrentSince Aug 1, 2017 Accepting new patients
Morris Anesthesia Group, PA CurrentSince Aug 1, 2017 Accepting new patients
Coastal Surgery Center, LLC Past Accepting new patients

Locations

495 Jack Martin Blvd
Ste 1
Brick, NJ 08724
Phone (732) 836-9800

25 Pocono Rd
Denville, NJ 07834
Phone (273) 625-6000

130 S Bryn Mawr Ave
Bryn Mawr, PA 19010
Phone (484) 337-3000

255 W Lancaster Ave
Paoli, PA 19301
Phone (484) 337-4286

610 W Germantown Pike
Ste 150
Plymouth Meeting, PA 19462
Phone (610) 526-3000

744 Lancaster Ave
Wayne, PA 19087
Phone (215) 244-7400

Organizations & group practices 4

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 3

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": "1334275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704931200000",
    "number": "1649537788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "610 W GERMANTOWN PIKE STE 150",
            "city": "PLYMOUTH MEETING",
            "state": "PA",
            "postal_code": "194621062",
            "telephone_number": "610-525-4966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 W LANCASTER AVE",
            "city": "PAOLI",
            "state": "PA",
            "postal_code": "193011763",
            "telephone_number": "484-565-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMUSA",
        "first_name": "GANIYU",
        "middle_name": "T.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-13",
        "last_updated": "2024-01-11",
        "certification_date": "2024-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NJ",
            "license": "25MA10047300",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "PA",
            "license": "MD475604",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Paoli, PA

Sources for this page

Verify at the official NPI Registry.