NPIMap

Organization Active NPI

Dodge Street Anesthesiologists PC

  • Anesthesiology Physician
  • Dubuque, IA
National Provider Identifier
1972533040
Registry record updated Apr 19, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
DODGE STREET ANESTHESIOLOGISTS PC
Practice address
1515 Delhi Street Suite 300
Dubuque, IA 52001-6320
Phone
(563) 557-8500
Fax
(563) 589-4078
NPI assigned
Jul 4, 2006
Last updated
Apr 19, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2013

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

Authorized official

Name
Sudhir Koneru, M.D.NPI 1659343630
Title
President
Phone
(563) 557-8500

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X NU
Anesthesiology Physician 207L00000X NU Primary

Addresses

Primary practice location

1515 Delhi Street Suite 300
Dubuque, IA 52001-6320

Mailing address

1515 Delhi Street Suite 300
Dubuque, IA 52001-6320
Phone (563) 557-8500

Other identifiers 1

IdentifierTypeStateIssuer
CP7443OtherIARAILROAD MEDICARE

Other names 1

  • DODGE STREET ANESTHESIA PC Other name

National Provider Directory

National Provider Directory

Locations

1515 Delhi St
Dubuque, IA 52001
Phone (315) 997-8500

Practitioners & affiliated clinicians

Practitioners 16

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.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1151971200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1366329600000",
    "number": "1972533040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1515 DELHI STREET SUITE 300",
            "city": "DUBUQUE",
            "state": "IA",
            "postal_code": "520016320",
            "telephone_number": "563-557-8500",
            "fax_number": "563-589-4078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 DELHI STREET SUITE 300",
            "city": "DUBUQUE",
            "state": "IA",
            "postal_code": "520016320",
            "telephone_number": "563-557-8500",
            "fax_number": "563-589-4078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DODGE STREET ANESTHESIOLOGISTS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-04",
        "last_updated": "2013-04-19",
        "status": "A",
        "authorized_official_last_name": "KONERU",
        "authorized_official_first_name": "SUDHIR",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "563-557-8500",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CP7443",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DODGE STREET ANESTHESIA PC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Dubuque, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2013; 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.