NPIMap

Organization Active NPI

Endoscopic Anesthesia Group, P.a.

  • Anesthesiology Physician
  • Orlando, FL
National Provider Identifier
1922311448
Registry record updated Sep 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
ENDOSCOPIC ANESTHESIA GROUP, P.A.
Practice address
1817 N Mills Ave
Orlando, FL 32803-1853
Phone
(407) 241-3268
Fax
(407) 241-3275
NPI assigned
Jul 26, 2010
Last updated
Sep 7, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2023

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

Authorized official

Name
Dr. William B. Ruderman, M.D.NPI 1598704843
Title
President
Phone
(407) 241-3268

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 NU Primary

Addresses

Primary practice location

1817 N Mills Ave
Orlando, FL 32803-1853

Mailing address

1817 N Mills Ave
Orlando, FL 32803-1853
Phone (407) 241-3268

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101108000533 FL Part B Supplier - Clinic/Group Practice 8325233000 Receives reassigned benefits from 30 practitioners
Practice locations: Orlando, FL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 31

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 31

NPI Registry JSON

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

{
    "created_epoch": "1280102400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1694044800000",
    "number": "1922311448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1817 N MILLS AVE",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328031853",
            "telephone_number": "407-241-3268",
            "fax_number": "407-241-3275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1817 N MILLS AVE",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328031853",
            "telephone_number": "407-241-3268",
            "fax_number": "407-241-3275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENDOSCOPIC ANESTHESIA GROUP, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-26",
        "last_updated": "2023-09-07",
        "status": "A",
        "authorized_official_last_name": "RUDERMAN",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "B.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "407-241-3268",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2023; 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.