Sandusky Bay Anesthesia, LLC

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

Legal business name

SANDUSKY BAY ANESTHESIA, LLC

Practice address

1101 Decatur St
Sandusky, OH 44870-3335

Phone

(918) 543-1020

Fax

(918) 543-2103

NPI assigned

Aug 5, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Matt S Wisniewski, C.R.N.A.NPI 1770543902

Title

President

Phone

(918) 543-1020

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 2

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.

• Matt S Wisniewski, C.R.N.A.

  • Certified Registered Nurse Anesthetist
  • Sandusky, OH
  • NPI 1770543902
  Authorized official Same address or phone
• Judy A Daus, C.R.N.A.

  • Certified Registered Nurse Anesthetist
  • Sandusky, OH
  • NPI 1104885540

  Nurse Anesthetist, Certified Registered

  NPD (past)

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

{
    "created_epoch": "1154736000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1750390274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 190",
            "city": "INOLA",
            "state": "OK",
            "postal_code": "740360190",
            "telephone_number": "918-543-1020",
            "fax_number": "918-543-2103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 DECATUR ST",
            "city": "SANDUSKY",
            "state": "OH",
            "postal_code": "448703335",
            "telephone_number": "918-543-1020",
            "fax_number": "918-543-2103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SANDUSKY BAY ANESTHESIA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-05",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WISNIEWSKI",
        "authorized_official_first_name": "MATT",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "918-543-1020",
        "authorized_official_credential": "C.R.N.A."
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2312492",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Christine M Samsa, D.O.
• Jacklyn Samuels, LPC
• Isabel Leigh-Ann Sanchez, CDCA
• Sandusky Artisans Cooperative
• Sandusky City Office of Treasurer (City of Sandusky Ambulance City of Sandusky EMS)
• Sandusky City School District
• Sandusky Dialysis LLC (Sandusky Dialysis Center)
• Sandusky Family Practice Inc
• Sandusky Gastroenterologists, Inc.

• Certified Registered Nurse Anesthetist in Sandusky, OH
• Providers in Sandusky, OH by specialty
• Certified Registered Nurse Anesthetist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.