NPIMap

Organization Active NPI

Ivs Anesthesia, LLC

  • Anesthesiology Physician
  • Andover, MA
National Provider Identifier
1740440163
Registry record updated Jan 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
44715 Issued in MA
Legal business name
IVS ANESTHESIA, LLC
Practice address
349 N Main St
Andover, MA 01810-2687
Phone
(978) 475-0959
Fax
(978) 475-1769
NPI assigned
Jun 10, 2008
Last updated
Jan 3, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2023

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

Authorized official

Name
Eduardo O D'Agostino, MDNPI 1912907718
Title
President
Phone
(781) 254-0334

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: 193400000X SINGLE SPECIALTY GROUP 207L00000X 44715 MA Primary

Addresses

Primary practice location

349 N Main St
Andover, MA 01810-2687

Mailing address

181 Wells Ave Ste 302
Newton, MA 02459-3344
Phone (781) 972-7136

Other practice location 1

91 Montvale Ave Ste 302
Stoneham, MA 02180-3649
Phone (781) 438-5995

Other identifiers 1

IdentifierTypeStateIssuer
110080230AMedicaidMA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20081201000530 MA Part B Supplier - Clinic/Group Practice 9537233010 Receives reassigned benefits from 19 practitioners
Practice locations: Andover, MA; Stoneham, MA

National Provider Directory

National Provider Directory

Locations

181 Wells Ave
Ste 302
Newton Center, MA 02459

91 Montvale Ave
Ste 302
Stoneham, MA 02180
Phone (781) 438-5995

Practitioners & affiliated clinicians

Practitioners 24

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 24

NPI Registry JSON

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

{
    "created_epoch": "1213056000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1672704000000",
    "number": "1740440163",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "181 WELLS AVE STE 302",
            "city": "NEWTON",
            "state": "MA",
            "postal_code": "024593344",
            "telephone_number": "781-972-7136",
            "fax_number": "781-972-7166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "349 N MAIN ST",
            "city": "ANDOVER",
            "state": "MA",
            "postal_code": "018102687",
            "telephone_number": "978-475-0959",
            "fax_number": "978-475-1769"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "91 Montvale Ave Ste 302",
            "address_purpose": "LOCATION",
            "city": "Stoneham",
            "state": "MA",
            "postal_code": "021803649",
            "country_code": "US",
            "telephone_number": "781-438-5995",
            "fax_number": "781-279-1238",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "IVS ANESTHESIA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-10",
        "last_updated": "2023-01-03",
        "certification_date": "2022-12-06",
        "status": "A",
        "authorized_official_last_name": "D'AGOSTINO",
        "authorized_official_first_name": "EDUARDO",
        "authorized_official_middle_name": "O",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "781-254-0334",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology",
            "state": "MA",
            "license": "44715",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110080230A",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Andover, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2023; 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.