NPIMap

Organization Active NPI

East Coast Anesthesia Associates PA

  • Anesthesiology Physician
  • Port St Lucie, FL
National Provider Identifier
1770756256
Registry record updated Mar 1, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
EAST COAST ANESTHESIA ASSOCIATES PA
Practice address
6830 S US Highway 1
Port St Lucie, FL 34952-1410
Phone
(772) 934-6443
NPI assigned
Apr 7, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2013

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

Authorized official

Name
Keith Ingram, MDNPI 1740235878
Title
Owner
Phone
(863) 357-6220

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 Primary

Addresses

Primary practice location

6830 S US Highway 1
Port St Lucie, FL 34952-1410

Mailing address

PO Box 1106
Stuart, FL 34995-1106
Phone (863) 357-6220

Other identifiers 1

IdentifierTypeStateIssuer
DN3309OtherMEDICARE RAILROAD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080702000357 FL Part B Supplier - Clinic/Group Practice 5890867139 Receives reassigned benefits from 8 practitioners
Practice locations: Port St. Lucie, FL; Hollywood, FL; Palm Springs, FL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1207526400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1362096000000",
    "number": "1770756256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1106",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349951106",
            "telephone_number": "863-357-6220",
            "fax_number": "863-357-6230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6830 S US HIGHWAY 1",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349521410",
            "telephone_number": "772-934-6443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST COAST ANESTHESIA ASSOCIATES PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-07",
        "last_updated": "2013-03-01",
        "status": "A",
        "authorized_official_last_name": "INGRAM",
        "authorized_official_first_name": "KEITH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "863-357-6220",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "DN3309",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Port St Lucie, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2013; 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.