NPIMap

Organization Active NPI

Southeast Anesthesia Assoc

  • Anesthesiology Physician
  • Dorchester Center, MA
National Provider Identifier
1891780078
Registry record updated Apr 6, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
SOUTHEAST ANESTHESIA ASSOC
Practice address
2100 Dorchester Ave
Dorchester Center, MA 02124-5615
Phone
(617) 506-2027
Fax
(617) 474-3811
NPI assigned
Sep 14, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2010

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

Authorized official

Name
Mr. Peter Tremlbay
Title
VP/Administrator
Phone
(617) 506-2028

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207L00000X Primary
Pain Medicine (Anesthesiology) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207LP2900X

Addresses

Primary practice location

2100 Dorchester Ave
Dorchester Center, MA 02124-5615

Mailing address

340 Main St
Ste. 670
Worcester, MA 01608-1604
Phone (508) 754-3566

Other identifiers 1

IdentifierTypeStateIssuer
9711341MedicaidMA

National Provider Directory

National Provider Directory

Locations

2100 Dorchester Ave
Fl 7
Dorchestr Ctr, MA 02124
Phone (617) 296-4012

Practitioners & affiliated clinicians

Practitioners 50

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

View all 50

NPI Registry JSON

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

{
    "created_epoch": "1126656000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1270512000000",
    "number": "1891780078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "340 MAIN ST",
            "address_2": "STE. 670",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016081604",
            "telephone_number": "508-754-3566",
            "fax_number": "508-798-8012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 DORCHESTER AVE",
            "city": "DORCHESTER CENTER",
            "state": "MA",
            "postal_code": "021245615",
            "telephone_number": "617-506-2027",
            "fax_number": "617-474-3811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEAST ANESTHESIA ASSOC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-14",
        "last_updated": "2010-04-06",
        "status": "A",
        "authorized_official_last_name": "TREMLBAY",
        "authorized_official_first_name": "PETER",
        "authorized_official_title_or_position": "VP/ADMINISTRATOR",
        "authorized_official_telephone_number": "617-506-2028",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9711341",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dorchester Center, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2010; 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.