Active NPI
Synergy Anesthesia CT PLLC
- Anesthesiology Physician
- San Diego, CA
National Provider Identifier
1952017113
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- Legal business name
- SYNERGY ANESTHESIA CT PLLC
- Practice address
- 12396 World Trade Dr Ste 303
San Diego, CA 92128-3792 - Phone
- (904) 614-5857
- NPI assigned
- Jan 30, 2023
- Organization subpart
- No
Authorized official
NPPES NPI Registry- Name
- Jay A Homburger, MD
- Title
- President
- Phone
- (904) 614-5857
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Practitioners 44
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CT
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20230320001420 | CT | Part B Supplier - Clinic/Group Practice | 1759755416 |
Receives reassigned benefits from 42 practitioners Practice locations: Waterbury, CT |
National Provider Directory
National Provider DirectoryLocations
12396 World Trade Dr
San Diego, CA 92128
Specialties & licenses 1
NPPES NPI Registry| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | Primary |
Addresses
NPPES NPI RegistryPrimary practice location
12396 World Trade Dr Ste 303
San Diego, CA 92128-3792
Mailing address
12396 World Trade Dr Ste 303
San Diego, CA 92128-3792
Phone (904) 614-5857
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jan 30, 2023.
{
"created_epoch": "1675036800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1675036800000",
"number": "1952017113",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12396 WORLD TRADE DR STE 303",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921283792",
"telephone_number": "904-614-5857"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12396 WORLD TRADE DR STE 303",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921283792",
"telephone_number": "904-614-5857"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SYNERGY ANESTHESIA CT PLLC",
"organizational_subpart": "NO",
"enumeration_date": "2023-01-30",
"last_updated": "2023-01-30",
"certification_date": "2023-01-30",
"status": "A",
"authorized_official_last_name": "HOMBURGER",
"authorized_official_first_name": "JAY",
"authorized_official_middle_name": "A",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "904-614-5857",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Anesthesiology",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 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.