NPIMap

Organization Active NPI

Pediatric Anesthesiologists P a

  • Anesthesiology Physician
  • Memphis, TN
National Provider Identifier
1720087802
Registry record updated Aug 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
PEDIATRIC ANESTHESIOLOGISTS P A
Practice address
50 N Dunlap St
Memphis, TN 38103-2800
Phone
(901) 572-3060
NPI assigned
Jul 20, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2022

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

Authorized official

Name
Dr. Vikram Patel Jr., MDNPI 1417922675
Title
President
Phone
(901) 291-2427

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207L00000X N/A TN
Anesthesiology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207L00000X Primary
Certified Registered Nurse AnesthetistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 367500000X

Addresses

Primary practice location

50 N Dunlap St
Memphis, TN 38103-2800

Mailing address

PO Box 342629
Bartlett, TN 38184-2629
Phone (901) 291-2400

Other identifiers 2

IdentifierTypeStateIssuer
3700547MedicaidTN
3621907MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040105000398 TN Part B Supplier - Clinic/Group Practice 0941109482 Receives reassigned benefits from 3 practitioners
Practice locations: Memphis, TN
O20040826000464 TN Part B Supplier - Clinic/Group Practice 0941109482 Receives reassigned benefits from 50 practitioners
Practice locations: Memphis, TN

National Provider Directory

National Provider Directory
Tax ID family
Pediatric Anesthesiologists P a2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

50 N Dunlap St
Memphis, TN 38103
Phone (901) 522-3060

Practitioners & affiliated clinicians

Practitioners 67

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

View all 67

NPI Registry JSON

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

{
    "created_epoch": "1121817600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1659657600000",
    "number": "1720087802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 342629",
            "city": "BARTLETT",
            "state": "TN",
            "postal_code": "381842629",
            "telephone_number": "901-291-2400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 N DUNLAP ST",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381032800",
            "telephone_number": "901-572-3060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC ANESTHESIOLOGISTS P A",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-20",
        "last_updated": "2022-08-05",
        "certification_date": "2022-08-05",
        "status": "A",
        "authorized_official_last_name": "PATEL",
        "authorized_official_first_name": "VIKRAM",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "901-291-2427",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology",
            "state": "TN",
            "license": "N/A",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "367500000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3700547",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3621907",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2022; 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.