NPIMap

Organization Active NPI

Prestige Anesthesia, PC

  • Anesthesiology Physician
  • Saginaw, MI
National Provider Identifier
1689445959
Registry record updated Mar 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
PRESTIGE ANESTHESIA, PC
Practice address
4450 Fashion Square Blvd Ste 200
Saginaw, MI 48603-1251
Phone
(989) 790-7950
NPI assigned
Jan 15, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2024

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

Authorized official

Name
Dr. Matthew Eagleson, DONPI 1295020048
Title
Owner/Physician
Phone
(989) 792-4090

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: 193200000X MULTI-SPECIALTY GROUP 207L00000X Primary

Addresses

Primary practice location

4450 Fashion Square Blvd Ste 200
Saginaw, MI 48603-1251

Mailing address

4450 Fashion Square Blvd Ste 500
Saginaw, MI 48603-1251
Phone (989) 558-0734

Other practice location 1

4450 Fashion Square Blvd
Saginaw, MI 48603-1251
Phone (989) 792-4090

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240315003067 MI Part B Supplier - Clinic/Group Practice 2668818329 Receives reassigned benefits from 11 practitioners
Practice locations: Saginaw, MI

National Provider Directory

National Provider Directory

Locations

4450 Fashion Square Blvd
Ste 500
Saginaw, MI 48603

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1705276800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1711411200000",
    "number": "1689445959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4450 FASHION SQUARE BLVD STE 500",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486031251",
            "telephone_number": "989-558-0734",
            "fax_number": "989-249-0227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4450 FASHION SQUARE BLVD STE 200",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486031251",
            "telephone_number": "989-790-7950"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4450 Fashion Square Blvd",
            "address_purpose": "LOCATION",
            "city": "Saginaw",
            "state": "MI",
            "postal_code": "486031251",
            "country_code": "US",
            "telephone_number": "989-792-4090",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PRESTIGE ANESTHESIA, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-15",
        "last_updated": "2024-03-26",
        "certification_date": "2024-03-26",
        "status": "A",
        "authorized_official_last_name": "EAGLESON",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_title_or_position": "OWNER/PHYSICIAN",
        "authorized_official_telephone_number": "989-792-4090",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saginaw, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2024; 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.