Individual provider Active NPI

Anwar Nassor

  • Anesthesiologist Assistant
  • Jacksonville, FL
National Provider Identifier
1972206100
Registry record updated Mar 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiologist AssistantTaxonomy code 367H00000X
License
367H00000X Issued in FL
Practice address
6675 Corporate Center Pkwy Ste 115
Jacksonville, FL 32216-8088
Phone
(904) 245-8910
NPI assigned
Mar 27, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiologist Assistant 367H00000X 367H00000X FL Primary

Addresses

Primary practice location

6675 Corporate Center Pkwy Ste 115
Jacksonville, FL 32216-8088

Mailing address

6675 Corporate Center Pkwy Ste 115
Jacksonville, FL 32216-8088
Phone (904) 245-8910

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240325000617 FL Practitioner - Anesthesiology Assistant 6901243120 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology Assistant
Education
Nova Southeastern Univ College of Dental Medicine, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anesthesiology Associates of Tallahassee IncGroup PAC ID 3476446014, 133 clinicians

Practice addresses (Care Compare)

2629 Welaunee Blvd
Tallahassee, FL 32308-4697
Phone (954) 939-5000

Hospital & facility affiliations

  • Tallahassee Memorial Healthcare Hospital, Tallahassee, FL, CCN 100135

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Associate of Arts

State licenses

LicenseStateTypeSpecialty
367H00000XFLMDAnesthesiologist Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesiology Associates of Tallahassee Inc CurrentSince Mar 1, 2024 Accepting new patients
Anesthesiology Associates of Tallahassee Inc CurrentSince Mar 1, 2024 Accepting new patients
Anesthesiology Associates of Tallahassee Inc Past Accepting new patients

Locations

2173 Centerville Pl
Ste A
Tallahassee, FL 32308

2626 Capital Medical Blvd
Tallahassee, FL 32308
Phone (850) 325-5000

2629 Welaunee Blvd
Tallahassee, FL 32308
Phone (850) 877-4688

1300 Miccosukee Rd
Tallahassee, FL 32308
Phone (850) 431-1155

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1679875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710374400000",
    "number": "1972206100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6675 CORPORATE CENTER PKWY STE 115",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322168088",
            "telephone_number": "904-245-8910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6675 CORPORATE CENTER PKWY STE 115",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322168088",
            "telephone_number": "904-245-8910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NASSOR",
        "first_name": "ANWAR",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-03-27",
        "last_updated": "2024-03-14",
        "certification_date": "2024-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367H00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiologist Assistant",
            "state": "FL",
            "license": "367H00000X",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.