Active NPI
South Tahoe Anesthesia Medical Group
- Pain Medicine (Anesthesiology) Physician
- South Lake Tahoe, CA
National Provider Identifier
1962513770
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pain Medicine (Anesthesiology) Physician
- License
- G54505
- Legal business name
- SOUTH TAHOE ANESTHESIA MEDICAL GROUP
- Practice address
- 2170 South Ave
South Lake Tahoe, CA 96150-7026 - Phone
- (530) 542-3000
- NPI assigned
- Aug 31, 2006
- Last updated
- Aug 22, 2020
- 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
- Baghdassar P Baghdikian
- Title
- MD
- Phone
- (530) 542-3000
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pain Medicine (Anesthesiology) Physician | 207LP2900X | G54505 | CA | Primary |
Addresses
Primary practice location
2170 South Ave
South Lake Tahoe, CA 96150-7026
Mailing address
5 Holland
Ste 101
Irvine, CA 92618-2566
Phone (949) 588-2190
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NV, CA
Enrollment records 2
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 17
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.
-
- Anesthesiology Physician
- Travis AFB, CA
- NPI 1750673570
-
- Anesthesiology Physician
- Napa, CA
- NPI 1467619353
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156982400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1962513770",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5 HOLLAND",
"address_2": "STE 101",
"city": "IRVINE",
"state": "CA",
"postal_code": "926182566",
"telephone_number": "949-588-2190"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2170 SOUTH AVE",
"city": "SOUTH LAKE TAHOE",
"state": "CA",
"postal_code": "961507026",
"telephone_number": "530-542-3000"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SOUTH TAHOE ANESTHESIA MEDICAL GROUP",
"organizational_subpart": "NO",
"enumeration_date": "2006-08-31",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "BAGHDIKIAN",
"authorized_official_first_name": "BAGHDASSAR",
"authorized_official_middle_name": "P",
"authorized_official_title_or_position": "MD",
"authorized_official_telephone_number": "530-542-3000"
},
"taxonomies": [
{
"code": "207LP2900X",
"taxonomy_group": "",
"desc": "Anesthesiology, Pain Medicine",
"state": "CA",
"license": "G54505",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in South Lake Tahoe, CA
- Samantha Snyder
- South Lake Tahoe
- South Lake Tahoe Family Resource Center
- South Lake Tahoe Recovery and Rehabilitation, LLC
- South Lake Tahoe Therapy, Licensed Clinical Social Worker Inc. (South Lake Tahoe Therapy)
- Delicia Marilyn Spees I
- Adam Spindler, DC
- Gail St.James, MFTI
- Jessica Marie Starr, PA
- Brian L Steixner, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.