Active NPI
Malabar Anesthesia Services Inc
- Anesthesiology Physician
- Mansfield, OH
National Provider Identifier
1922497940
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- Legal business name
- MALABAR ANESTHESIA SERVICES INC
- Practice address
- 335 Glessner Ave
Mansfield, OH 44903-2269 - Phone
- (419) 775-7877
- NPI assigned
- Jan 14, 2015
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- John R Johnson, CRNA
- Title
- Owner
- Phone
- (419) 775-7877
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | Primary |
Addresses
Primary practice location
335 Glessner Ave
Mansfield, OH 44903-2269
Mailing address
PO Box 182255
Columbus, OH 43218-2255
Phone (419) 775-7877
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0117130 | Medicaid | OH | |
| H323850 | Other | OH | MEDICARE PTAN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OH
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20150612001359 | OH | Part B Supplier - Clinic/Group Practice | 9234440561 |
Receives reassigned benefits from 43 practitioners Practice locations: Columbus, OH; Mansfield, OH; Newark, OH; Ontario, OH |
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 44
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": "1421193600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1439942400000",
"number": "1922497940",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 182255",
"city": "COLUMBUS",
"state": "OH",
"postal_code": "432182255",
"telephone_number": "419-775-7877"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "335 GLESSNER AVE",
"city": "MANSFIELD",
"state": "OH",
"postal_code": "449032269",
"telephone_number": "419-775-7877"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MALABAR ANESTHESIA SERVICES INC",
"organizational_subpart": "NO",
"enumeration_date": "2015-01-14",
"last_updated": "2015-08-19",
"status": "A",
"authorized_official_last_name": "JOHNSON",
"authorized_official_first_name": "JOHN",
"authorized_official_middle_name": "R",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "419-775-7877",
"authorized_official_credential": "CRNA"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Anesthesiology",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0117130",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE PTAN",
"identifier": "H323850",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Mansfield, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2015; 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.