NPIMap

Organization Active NPI

Orange City Anesthesia Services LLC

  • Anesthesiology Physician
  • Orange City, FL
National Provider Identifier
1972882314
Registry record updated May 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
ORANGE CITY ANESTHESIA SERVICES LLC
Practice address
975 Town Center Dr Ste 100
Orange City, FL 32763
Phone
(386) 456-5247
Fax
(386) 456-0122
NPI assigned
Aug 16, 2011
Last updated
May 25, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
SURGERY CENTER HOLDINGS INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on May 25, 2021

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

Authorized official

Name
Jeff Parks
Title
Senior Vice President
Phone
(813) 569-6500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X NU Primary

Addresses

Primary practice location

975 Town Center Dr Ste 100
Orange City, FL 32763

Mailing address

4919 Memorial Hwy Ste 200
Tampa, FL 33634-7500
Phone (239) 610-0775

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20111208000641 FL Part B Supplier - Clinic/Group Practice 2365617016 Receives reassigned benefits from 130 practitioners
Practice locations: Lake Mary, FL; Orange City, FL

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 134

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 134

NPI Registry JSON

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

{
    "created_epoch": "1313452800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1621900800000",
    "number": "1972882314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4919 MEMORIAL HWY STE 200",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336347500",
            "telephone_number": "239-610-0775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "975 TOWN CENTER DR STE 100",
            "city": "ORANGE CITY",
            "state": "FL",
            "postal_code": "32763",
            "telephone_number": "386-456-5247",
            "fax_number": "386-456-0122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORANGE CITY ANESTHESIA SERVICES LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SURGERY CENTER HOLDINGS INC.",
        "enumeration_date": "2011-08-16",
        "last_updated": "2021-05-25",
        "certification_date": "2021-05-25",
        "status": "A",
        "authorized_official_last_name": "PARKS",
        "authorized_official_first_name": "JEFF",
        "authorized_official_title_or_position": "SENIOR VICE PRESIDENT",
        "authorized_official_telephone_number": "813-569-6500"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange City, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2021; 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.

Verify at the official NPI Registry.