Individual provider Active NPI

Airadion Omoruan, MD

  • Anesthesiology Physician
  • Boston, MA
National Provider Identifier
1831358449
Registry record updated Jun 9, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
L-236353 Issued in MA
Practice address
Massachusetts General Hospital
55 Fruit Street
Boston, MA 02114
Phone
(617) 726-3030
NPI assigned
Jun 9, 2008
Last updated
Jun 9, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X L-236353 MA Primary

Addresses

Primary practice location

Massachusetts General Hospital
55 Fruit Street
Boston, MA 02114

Mailing address

Massachusetts General Hospital
55 Fruit Street
Boston, MA 02114
Phone (617) 726-3030

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140917000007 WA Practitioner - AnesthesiologyPractitioner - Internal Medicine 2264690825 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Clvlnd Clinic Lerner College of Med of Case WSTN RSV University, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tacoma Anesthesia Associates Inc PSGroup PAC ID 6002704475, 63 clinicians

Practice addresses (Care Compare)

1901 S Union Ave
Tacoma, WA 98405-1702
Phone (253) 459-6200

315 Martin Luther King Jr Way
Tacoma, WA 98405-4234
Phone (253) 274-1668

316 Martin Luther King Jr Way
Tacoma, WA 98405-4252
Phone (253) 403-3370

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
L-236353MAMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tacoma Anesthesia Associates Inc PS Anesthesiology CurrentSince Jul 28, 2014 Accepting new patients

Locations

315 S K St
Tacoma, WA 98405
Phone (253) 403-1291

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1212969600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1212969600000",
    "number": "1831358449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "MASSACHUSETTS GENERAL HOSPITAL",
            "address_2": "55 FRUIT STREET",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "02114",
            "telephone_number": "617-726-3030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MASSACHUSETTS GENERAL HOSPITAL",
            "address_2": "55 FRUIT STREET",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "02114",
            "telephone_number": "617-726-3030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OMORUAN",
        "first_name": "AIRADION",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-09",
        "last_updated": "2008-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MA",
            "license": "L-236353",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.