NPIMap

Organization Active NPI

Amsurg Marin Anesthesia LP

  • Anesthesiology Physician
  • Greenbrae, CA
National Provider Identifier
1972929925
Registry record updated Sep 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
AMSURG MARIN ANESTHESIA LP
Practice address
1100 South Elisco Drive
Suite 3
Greenbrae, CA 94904-2017
Phone
(415) 464-0606
Fax
(415) 646-0644
NPI assigned
Mar 14, 2014
Last updated
Sep 7, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2023

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

Authorized official

Name
Mr. Phillip Clendenin
Title
President
Phone
(615) 665-1283

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207L00000X Primary

Addresses

Primary practice location

1100 South Elisco Drive
Suite 3
Greenbrae, CA 94904-2017

Mailing address

20 Burton Hills Blvd
Suite 500, Attn: L&C
Nashville, TN 37215-6197
Phone (615) 240-3820

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140603000058 CA Part B Supplier - Clinic/Group Practice 7214160191 Receives reassigned benefits from 37 practitioners
Practice locations: Greenbrae, CA

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 37

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 37

NPI Registry JSON

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

{
    "created_epoch": "1394755200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1694044800000",
    "number": "1972929925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 BURTON HILLS BLVD",
            "address_2": "SUITE 500, ATTN: L&C",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372156197",
            "telephone_number": "615-240-3820",
            "fax_number": "615-234-1720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 SOUTH ELISCO DRIVE",
            "address_2": "SUITE 3",
            "city": "GREENBRAE",
            "state": "CA",
            "postal_code": "949042017",
            "telephone_number": "415-464-0606",
            "fax_number": "415-646-0644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMSURG MARIN ANESTHESIA LP",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-14",
        "last_updated": "2023-09-07",
        "status": "A",
        "authorized_official_last_name": "CLENDENIN",
        "authorized_official_first_name": "PHILLIP",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "615-665-1283",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenbrae, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2023; 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.