Anesthesia Medical Group of Santa Cruz, Inc.
Organization Active NPI Anesthesiology Physician · Santa Cruz, CA
NPI 1871541144 · NPPES record last updated Aug 22, 2020
Key facts
- NPI
- 1871541144
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Anesthesiology Physician 207L00000X
- Legal business name
- ANESTHESIA MEDICAL GROUP OF SANTA CRUZ, INC.
- Practice address
- 1555 Soquel Dr
Santa Cruz, CA 95065-1705 - Phone
- (831) 462-7700
- NPI assigned
- May 5, 2006
- Organization subpart
- No
Authorized official
- Name
- Mark L. Rigler, MD
- Title
- Group President
- Phone
- (503) 372-2740
Practitioners 58
-
Gina C Bane, M.D.
-
Vivian Banh, DO
-
Jennifer Jou, M.D.
-
Grace Kibuule, MD
-
Roberto M Kong, MD
-
Shannon McManis, M.D.
-
Steven Thomas Wai, M.D.
-
Paul Bennett Yost, M.D.
-
Lisa C Ferguson, MD
-
Lawrence Ong, M.D., M.ENG.
-
Carolina Cernicica Bagga, M.D.
-
Raimy Boban, M.D.
-
Ronald J. Braun, M.D.
-
Aparna Dalal, MD
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20070816000914 | CA | Part B Supplier - Clinic/Group Practice | 5092807271 |
Receives reassigned benefits from 45 practitioners Practice locations: Santa Cruz, CA; Freedom, CA; Capitola, CA |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician |
207L00000X | Yes |
Addresses
Primary practice location
1555 Soquel Dr
Santa Cruz, CA 95065-1705
Mailing address
PO Box 7793
San Francisco, CA 94120-7793
Phone (503) 372-2740
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| GR0060850 | Medicaid | CA |
Other providers in Santa Cruz, CA
- Dante Andres Jr.
- Laurel M. Andres
- Andrew Moreland M.D., Inc
- Ann W. Andrews
- George Anerousis
- Angela Kuo Choy DDS Inc
- Jena Angelo
- Paul Angelo
- Eliza Nichole Angila
- Lisset Angulo Lupercio
All providers in Santa Cruz, CA · Anesthesiology Physician in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 22, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.