NPIMap

Organization Active NPI

North Shore Ambulatory Anesthesia Partners LLC

  • Anesthesiology Physician
  • Peabody, MA
National Provider Identifier
1821535378
Registry record updated Mar 31, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
NORTH SHORE AMBULATORY ANESTHESIA PARTNERS LLC
Practice address
1 Orthopedics Dr
Peabody, MA 01960-1668
Phone
(978) 818-6500
NPI assigned
Jan 23, 2017
Last updated
Mar 31, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2021

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

Authorized official

Name
Mark H. Dougherty, MDNPI 1427016542
Title
Authorized Official
Phone
(978) 818-6500

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

1 Orthopedics Dr
Peabody, MA 01960-1668

Mailing address

1 Orthopedics Dr
Peabody, MA 01960-1668
Phone (877) 868-6804

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170411000316 MA Part B Supplier - Clinic/Group Practice 7416233234 Receives reassigned benefits from 14 practitioners
Practice locations: Peabody, MA

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, and the practitioner matching its NPPES authorized official.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1485129600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1617148800000",
    "number": "1821535378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 ORTHOPEDICS DR",
            "city": "PEABODY",
            "state": "MA",
            "postal_code": "019601668",
            "telephone_number": "877-868-6804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 ORTHOPEDICS DR",
            "city": "PEABODY",
            "state": "MA",
            "postal_code": "019601668",
            "telephone_number": "978-818-6500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH SHORE AMBULATORY ANESTHESIA PARTNERS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-23",
        "last_updated": "2021-03-31",
        "certification_date": "2021-03-31",
        "status": "A",
        "authorized_official_last_name": "DOUGHERTY",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "H.",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "978-818-6500",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peabody, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2021; 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.