NPIMap

Holy Cross Anesthesiology Associate PA

Organization Active NPI Anesthesiology Physician · Potomac, MD

NPI 1992528467 · NPPES record last updated Nov 4, 2024

Key facts

NPI
1992528467
Entity type
Organization (NPI type 2)
Primary specialty
Anesthesiology Physician 207L00000X
Legal business name
HOLY CROSS ANESTHESIOLOGY ASSOCIATE PA
Practice address
12435 Park Potomac Ave Ste 410
Potomac, MD 20854-7037
Phone
(866) 953-3111
NPI assigned
Nov 4, 2024
Organization subpart
Yes
Parent organization (as reported)
HOLY CROSS ANESTHESIOLOGY ASSOCIATE PA

Authorized official

Name
Sara Depew
Title
President
Phone
(347) 731-2133

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Corporate family (same tax ID) 17

Organizations that report the same tax identification number in the National Provider Directory.

National Provider Directory

Tax ID family
Holy Cross Anesthesiolo (18 organizations share this tax ID)
Part of
Holy Cross Anesthesiolo

Locations

12435 Park Potomac Ave
Ste 410
Potomac, MD 20854
Phone (301) 309-8219

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 207L00000X Yes
Certified Registered Nurse Anesthetist
Group: 193200000X MULTI-SPECIALTY GROUP		 367500000X

Addresses

Primary practice location

12435 Park Potomac Ave Ste 410
Potomac, MD 20854-7037

Mailing address

PO Box 64605
Baltimore, MD 21264-4605

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Nov 4, 2024.

{
    "created_epoch": "1730678400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730678400000",
    "number": "1992528467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 64605",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212644605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12435 PARK POTOMAC AVE STE 410",
            "city": "POTOMAC",
            "state": "MD",
            "postal_code": "208547037",
            "telephone_number": "866-953-3111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOLY CROSS ANESTHESIOLOGY ASSOCIATE PA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HOLY CROSS ANESTHESIOLOGY ASSOCIATE PA",
        "enumeration_date": "2024-11-04",
        "last_updated": "2024-11-04",
        "certification_date": "2024-11-04",
        "status": "A",
        "authorized_official_last_name": "DEPEW",
        "authorized_official_first_name": "SARA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "347-731-2133"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "367500000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Potomac, MD

All providers in Potomac, MD · Anesthesiology Physician in Maryland

Sources for this page

Verify at the official NPI Registry.