Individual provider Active NPI

Kenneth A O'Beirne II, MD

  • Anesthesiology Physician
  • Toledo, OH
National Provider Identifier
1740397629
Registry record updated Aug 8, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
2006019885 Issued in MO
Practice address
3404 W Sylvania Ave
Toledo, OH 43623-4467
Phone
(419) 407-2480
NPI assigned
Aug 24, 2006
Last updated
Aug 8, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 2006019885 MO Primary

Addresses

Primary practice location

3404 W Sylvania Ave
Toledo, OH 43623-4467

Mailing address

2200 Jefferson Ave
4TH Floor
Toledo, OH 43604-7101
Phone (419) 251-2673

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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 1

Enrollment IDStateProvider typePAC IDDetails
I20090918000127 AZ Practitioner - Anesthesiology 4880740729 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Prescott Anesthesia PLLCGroup PAC ID 4385536929, 16 clinicians

Practice addresses (Care Compare)

1003 Willow Creek Rd
Prescott, AZ 86301-1641
Phone (928) 771-5657

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2006019885MOMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Prescott Anesthesia PLLC Anesthesiology CurrentSince Aug 15, 2016 Accepting new patients
Verde Valley Medical Center Past Accepting new patients

Locations

1003 Willow Creek Rd
Prescott, AZ 86301
Phone (928) 445-2700

5430 Distinction Way
Prescott, AZ 86301
Phone (928) 445-1919

Organizations & group practices 2

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 1

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": "1156377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1312761600000",
    "number": "1740397629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 JEFFERSON AVE",
            "address_2": "4TH FLOOR",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436047101",
            "telephone_number": "419-251-2673",
            "fax_number": "419-251-0916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3404 W SYLVANIA AVE",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436234467",
            "telephone_number": "419-407-2480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'BEIRNE",
        "first_name": "KENNETH",
        "middle_name": "A",
        "name_suffix": "II",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-24",
        "last_updated": "2011-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MO",
            "license": "2006019885",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Toledo, OH

Sources for this page

Verify at the official NPI Registry.