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Keystone Anesthesia Consultants, LTD

Organization Active NPI Anesthesiology Physician · Washington, PA

NPI 1861450751 · NPPES record last updated Mar 17, 2018

Key facts

NPI
1861450751
Entity type
Organization (NPI type 2)
Primary specialty
Anesthesiology Physician 207L00000X
Legal business name
KEYSTONE ANESTHESIA CONSULTANTS, LTD
Practice address
80 Landings Dr Ste 202
Washington, PA 15301-9408
Phone
(724) 969-0191
Fax
(724) 941-9089
NPI assigned
May 2, 2006
Organization subpart
No

Authorized official

Name
James Massucci, M,D. NPI 1134190382
Title
President
Phone
(412) 942-5786

Authorized official NPPES reports the authorized official by name only; the link goes to the one practitioner connected to this organization with that name.

Member organizations 2

Organizations listed as members of this organization in the National Provider Directory.

Practitioners 165

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

View all 165

Medicare participation

Medicare fee-for-service enrollment
Enrolled (2 enrollments) in PA, OH

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20040226000073 PA Part B Supplier - Clinic/Group Practice 2769378751 Receives reassigned benefits from 138 practitioners
Practice locations: Washington, PA; Sharon, PA; Pittsburgh, PA; Bethel Park, PA
O20220809000384 OH Part B Supplier - Clinic/Group Practice 2769378751 Receives reassigned benefits from 31 practitioners
Practice locations: Cortland, OH; Warren, OH

National Provider Directory

Locations

2000 Oxford Dr
Ste 303
Bethel Park, PA 15102
Phone (412) 572-6066

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 207L00000X Yes
Pain Medicine Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 208VP0000X
Interventional Pain Medicine Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 208VP0014X

Addresses

Primary practice location

80 Landings Dr Ste 202
Washington, PA 15301-9408

Mailing address

2000 Oxford Dr
Suite 303
Bethel Park, PA 15102-1827
Phone (412) 942-5786

Other practice location 1

2000 Oxford Dr
Suite 303
Bethel Park, PA 15102-1827
Phone (412) 942-5786

Other identifiers

IdentifierTypeStateIssuer
009769480004MedicaidPA

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Mar 17, 2018.

{
    "created_epoch": "1146528000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1521244800000",
    "number": "1861450751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 OXFORD DR",
            "address_2": "SUITE 303",
            "city": "BETHEL PARK",
            "state": "PA",
            "postal_code": "151021827",
            "telephone_number": "412-942-5786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 LANDINGS DR STE 202",
            "city": "WASHINGTON",
            "state": "PA",
            "postal_code": "153019408",
            "telephone_number": "724-969-0191",
            "fax_number": "724-941-9089"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2000 Oxford Dr",
            "address_2": "Suite 303",
            "address_purpose": "LOCATION",
            "city": "Bethel Park",
            "state": "PA",
            "postal_code": "151021827",
            "country_code": "US",
            "telephone_number": "412-942-5786",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "KEYSTONE ANESTHESIA CONSULTANTS, LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-02",
        "last_updated": "2018-03-17",
        "status": "A",
        "authorized_official_last_name": "MASSUCCI",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "412-942-5786",
        "authorized_official_credential": "M,D."
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Pain Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009769480004",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, PA

All providers in Washington, PA · Anesthesiology Physician in Pennsylvania

Sources for this page

Verify at the official NPI Registry.