Individual provider Active NPI

Nathan H Jorgensen, MD

  • Anesthesiology Physician
  • Dover, NH
National Provider Identifier
1972580314
Registry record updated Mar 19, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
9363 Issued in NH
Practice address
789 Central Ave
Dover, NH 03820-2526
Phone
(603) 749-7246
Fax
(603) 749-2453
NPI assigned
Dec 28, 2005
Last updated
Mar 19, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 9363 NH Primary

Addresses

Primary practice location

789 Central Ave
Dover, NH 03820-2526

Mailing address

3998 Fair Ridge Dr
Ste 300
Fairfax, VA 22033-2921
Phone (703) 295-9360

Other identifiers 1

IdentifierTypeStateIssuer
30007945MedicaidNH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH, ME2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20050211000416 NH Practitioner - AnesthesiologyPractitioner - Pain Management 3173575701 Reassigns benefits to 3 organizations
I20230821000968 ME Practitioner - Anesthesiology 3173575701

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Wentworth Douglass Physician Corporation CurrentSince Oct 29, 2019 Accepting new patients
North American Partners in Anesthesia New Hampshire LLP Anesthesiology CurrentSince May 10, 2016 Accepting new patients
Wentworth Douglass Physician Corporation CurrentSince Oct 29, 2019 Accepting new patients
Anesthesia Care Group PC Anesthesiology CurrentSince Jan 22, 2018 Accepting new patients

Locations

750 Central Ave
Ste Q
Dover, NH 03820
Phone (603) 742-6030

789 Central Ave
Dover, NH 03820
Phone (603) 740-2832

100 McGregor St
Manchester, NH 03102
Phone (603) 663-6931

88 McGregor St
Ste 303
Manchester, NH 03102
Phone (603) 647-9325

11 Whitehall Rd
Rochester, NH 03867
Phone (603) 330-7905

7 Marsh Brook Dr
Ste 10
Somersworth, NH 03878
Phone (603) 749-7246

68 S Service Rd
Ste 350
Melville, NY 11747
Phone (516) 945-3107

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1135728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1426723200000",
    "number": "1972580314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3998 FAIR RIDGE DR",
            "address_2": "STE 300",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220332921",
            "telephone_number": "703-295-9360",
            "fax_number": "703-766-9725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "789 CENTRAL AVE",
            "city": "DOVER",
            "state": "NH",
            "postal_code": "038202526",
            "telephone_number": "603-749-7246",
            "fax_number": "603-749-2453"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORGENSEN",
        "first_name": "NATHAN",
        "middle_name": "H",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-28",
        "last_updated": "2015-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NH",
            "license": "9363",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30007945",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dover, NH

Sources for this page

Verify at the official NPI Registry.