NPIMap

Organization Active NPI

Fidere Anesthesia Consultants, Inc.

  • Anesthesiology Physician
  • Mountain View, CA
National Provider Identifier
1790855161
Registry record updated Dec 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
FIDERE ANESTHESIA CONSULTANTS, INC.
Practice address
2500 Grant Rd
Mountain View, CA 94040
Phone
(650) 903-9500
Fax
(650) 903-9900
NPI assigned
Nov 9, 2006
Last updated
Dec 18, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2020

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

Authorized official

Name
Kahty Kondas
Title
Ao
Phone
(954) 838-2371

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X
Anesthesiology Physician 207L00000X Primary
Critical Care Medicine (Anesthesiology) Physician 207LC0200X

Addresses

Primary practice location

2500 Grant Rd
Mountain View, CA 94040

Mailing address

PO Box 744653
Atlanta, GA 30374-4653
Phone (866) 678-4320

Other identifiers 2

IdentifierTypeStateIssuer
GR0042170MedicaidCA
ZZZ18212ZOtherCABLUE SHIELD

Other names 1

  • FREMONT ANESTHESIA CONSULTANTS MEDICAL GROUP, INC. Former legal business name

National Provider Directory

National Provider Directory

Locations

1422 El Camino Real
Menlo Park, CA 94025
Phone (650) 903-9500

1174 Castro St
Ste 200201
Mountain View, CA 94040
Phone (650) 691-9435

2420 Samaritan Dr
San Jose, CA 95124
Phone (408) 369-5600

Practitioners & affiliated clinicians

Practitioners 12

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.

NPI Registry JSON

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

{
    "created_epoch": "1163030400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1608249600000",
    "number": "1790855161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 744653",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303744653",
            "telephone_number": "866-678-4320",
            "fax_number": "650-903-9900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 GRANT RD",
            "city": "MOUNTAIN VIEW",
            "state": "CA",
            "postal_code": "94040",
            "telephone_number": "650-903-9500",
            "fax_number": "650-903-9900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FIDERE ANESTHESIA CONSULTANTS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-09",
        "last_updated": "2020-12-18",
        "certification_date": "2020-12-18",
        "status": "A",
        "authorized_official_last_name": "KONDAS",
        "authorized_official_first_name": "KAHTY",
        "authorized_official_title_or_position": "AO",
        "authorized_official_telephone_number": "954-838-2371"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207LC0200X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Critical Care Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0042170",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "ZZZ18212Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FREMONT ANESTHESIA CONSULTANTS MEDICAL GROUP, INC.",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "FREMONT ANESTHESIA CONSULTANTS MEDICAL GROUP, INC.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Mountain View, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 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.