NPIMap

Organization Active NPI

Oxford Anesthesia Management, LLC

  • Anesthesiology Physician
  • The Dalles, OR
National Provider Identifier
1669077707
Registry record updated May 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
OXFORD ANESTHESIA MANAGEMENT, LLC
Practice address
Mid-Columbia Medical Center
1700 E 19TH Street
The Dalles, OR 97058-3317
Phone
(541) 296-7760
NPI assigned
Dec 4, 2020
Last updated
May 4, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 4, 2021

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

Authorized official

Name
Alex Gorecki
Title
Chief Operating Officer
Phone
(850) 497-6702

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207L00000X Primary

Addresses

Primary practice location

Mid-Columbia Medical Center
1700 E 19TH Street
The Dalles, OR 97058-3317

Mailing address

PO Box 69355
Baltimore, MD 21264-9355
Phone (833) 352-0096

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210224000625 OR Part B Supplier - Clinic/Group Practice 1355756461 Receives reassigned benefits from 15 practitioners
Practice locations: The Dalles, OR

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 15

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 15

NPI Registry JSON

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

{
    "created_epoch": "1607040000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1620086400000",
    "number": "1669077707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 69355",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212649355",
            "telephone_number": "833-352-0096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MID-COLUMBIA MEDICAL CENTER",
            "address_2": "1700 E 19TH STREET",
            "city": "THE DALLES",
            "state": "OR",
            "postal_code": "970583317",
            "telephone_number": "541-296-7760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OXFORD ANESTHESIA MANAGEMENT, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-04",
        "last_updated": "2021-05-04",
        "certification_date": "2021-05-04",
        "status": "A",
        "authorized_official_last_name": "GORECKI",
        "authorized_official_first_name": "ALEX",
        "authorized_official_title_or_position": "CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "850-497-6702"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in The Dalles, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 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.