NPIMap

Organization Active NPI

Physicians' Ambulatory Anesthesia Services, LLC

  • Anesthesiology Physician
  • Bridgeton, MO
National Provider Identifier
1942596002
Registry record updated Jun 27, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
PHYSICIANS' AMBULATORY ANESTHESIA SERVICES, LLC
Practice address
12266 Depaul Drive
Bridgeton, MO 63044-2514
Phone
(314) 291-7500
Fax
(314) 291-7501
NPI assigned
Jun 27, 2011
Last updated
Jun 27, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2011

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

Authorized official

Name
Dr. Jama Mohmoud, M.D.
Title
President
Phone
(314) 283-8498

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

12266 Depaul Drive
Bridgeton, MO 63044-2514

Mailing address

1860 Gatemont Dr
Chesterfield, MO 63017-8012
Phone (314) 283-8498

National Provider Directory

National Provider Directory

Locations

7061 Solutions Ctr
Chicago, IL 60677

Practitioners & affiliated clinicians

Practitioners 12

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.

NPI Registry JSON

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

{
    "created_epoch": "1309132800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1309132800000",
    "number": "1942596002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1860 GATEMONT DR",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630178012",
            "telephone_number": "314-283-8498",
            "fax_number": "636-220-4132"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12266 DEPAUL DRIVE",
            "city": "BRIDGETON",
            "state": "MO",
            "postal_code": "630442514",
            "telephone_number": "314-291-7500",
            "fax_number": "314-291-7501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICIANS' AMBULATORY ANESTHESIA SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-27",
        "last_updated": "2011-06-27",
        "status": "A",
        "authorized_official_last_name": "MOHMOUD",
        "authorized_official_first_name": "JAMA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "314-283-8498",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "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": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bridgeton, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2011; 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.