NPIMap

Organization Active NPI

Ambulatory Anesthesia Services, LLC

  • Anesthesiology Physician
  • Willoughby, OH
National Provider Identifier
1922270495
Registry record updated Jun 17, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
AMBULATORY ANESTHESIA SERVICES, LLC
Practice address
6025 Commerce Cir
Suite 2
Willoughby, OH 44094-9668
Phone
(440) 944-1414
Fax
(440) 944-1445
NPI assigned
Mar 25, 2008
Last updated
Jun 17, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2011

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

Authorized official

Name
David Demangone, M.D.NPI 1548225832
Title
Owner
Phone
(440) 944-1414

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X OH Primary

Addresses

Primary practice location

6025 Commerce Cir
Suite 2
Willoughby, OH 44094-9668

Mailing address

PO Box 5100
Mentor, OH 44061-5100
Phone (440) 944-1414

Other identifiers 2

IdentifierTypeStateIssuer
DQ2764OtherOHRAILROAD MEDICARE
3016426MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080502000242 OH Part B Supplier - Clinic/Group Practice 5294814240 Receives reassigned benefits from 9 practitioners
Practice locations: Willoughby, OH

National Provider Directory

National Provider Directory

Locations

6025 Commerce Cir
Ste 1
Willoughby, OH 44094
Phone (440) 525-2750

6025 Commerce Cir
Ste 2
Willoughby, OH 44094
Phone (440) 585-2750

Practitioners & affiliated clinicians

Practitioners 15

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1206403200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1308268800000",
    "number": "1922270495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5100",
            "city": "MENTOR",
            "state": "OH",
            "postal_code": "440615100",
            "telephone_number": "440-944-1414",
            "fax_number": "440-944-1445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6025 COMMERCE CIR",
            "address_2": "SUITE 2",
            "city": "WILLOUGHBY",
            "state": "OH",
            "postal_code": "440949668",
            "telephone_number": "440-944-1414",
            "fax_number": "440-944-1445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMBULATORY ANESTHESIA SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-25",
        "last_updated": "2011-06-17",
        "status": "A",
        "authorized_official_last_name": "DEMANGONE",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "440-944-1414",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "OH",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DQ2764",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3016426",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Willoughby, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.