Organization Active NPI

Victoria Anesthesiology Assoc LLP

  • Anesthesiology Physician
  • Victoria, TX
National Provider Identifier
1881709780
Registry record updated Aug 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
VICTORIA ANESTHESIOLOGY ASSOC LLP
Practice address
1501 E Mockingbird LN
Suite 101
Victoria, TX 77904-2155
Phone
(361) 573-6291
Fax
(361) 576-2434
NPI assigned
Aug 20, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2016

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

Authorized official

Name
Buddy R Nielsen, MD
Title
MD
Phone
(361) 573-2481

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207L00000X Primary
Certified Registered Nurse AnesthetistGroup: 193200000X MULTI-SPECIALTY GROUP 367500000X

Addresses

Primary practice location

1501 E Mockingbird LN
Suite 101
Victoria, TX 77904-2155

Mailing address

PO Box 4897
Houston, TX 77210-4897
Phone (361) 573-6291

Other identifiers 5

IdentifierTypeStateIssuer
0841793-02MedicaidTX
00N42XMedicaidTX
CD3812OtherTXRR MEDICARE
C31NOtherTXBCBS TX CRNAS
00N42XOtherTXBLUE CROSS GRP MD

National Provider Directory

National Provider Directory

Locations

1501 E Mockingbird Ln
Ste 101
Victoria, TX 77904
Phone (361) 513-6291

1501 E Mockingbird Ln
Ste 200
Victoria, TX 77904
Phone (316) 573-6291

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1156032000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1471478400000",
    "number": "1881709780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4897",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "772104897",
            "telephone_number": "361-573-6291",
            "fax_number": "361-576-2434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 E MOCKINGBIRD LN",
            "address_2": "SUITE 101",
            "city": "VICTORIA",
            "state": "TX",
            "postal_code": "779042155",
            "telephone_number": "361-573-6291",
            "fax_number": "361-576-2434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VICTORIA ANESTHESIOLOGY ASSOC LLP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-20",
        "last_updated": "2016-08-18",
        "status": "A",
        "authorized_official_last_name": "NIELSEN",
        "authorized_official_first_name": "BUDDY",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "361-573-2481",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "367500000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0841793-02",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00N42X",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "CD3812",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS TX CRNAS",
            "identifier": "C31N",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS GRP MD",
            "identifier": "00N42X",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Victoria, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2016; 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.