NPIMap

Organization Active NPI

Gulfstream Anesthesia Consultants PA

  • Anesthesiology Physician
  • Troy, PA
National Provider Identifier
1992713242
Registry record updated Apr 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
GULFSTREAM ANESTHESIA CONSULTANTS PA
Practice address
275 Guthrie Dr
Troy, PA 16947-8115
Phone
(877) 204-4155
Fax
(877) 213-5232
NPI assigned
Aug 3, 2006
Last updated
Apr 28, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2022

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

Authorized official

Name
Lawrence M Reid, MDNPI 1649288937
Title
President
Phone
(561) 204-5230

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
Anesthesiology Physician 207L00000X Primary

Addresses

Primary practice location

275 Guthrie Dr
Troy, PA 16947-8115

Mailing address

PO Box 212110
Royal Palm Beach, FL 33421-2110
Phone (877) 204-4155

Other identifiers 2

IdentifierTypeStateIssuer
1012390590002MedicaidPA
1012390590001MedicaidPA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address Kris@gulfstreamanesthesia.com Direct

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050601000415 PA Part B Supplier - Clinic/Group Practice 2365418241 Receives reassigned benefits from 76 practitioners
Practice locations: Towanda, PA; Wilkes Barre, PA; Troy, PA; Sunbury, PA; Plains, PA; Lock Haven, PA; Hazleton, PA; Hazle Township, PA…

National Provider Directory

National Provider Directory

Locations

11440 Okeechobee Blvd
Ste 103
Royal Palm Beach, FL 33411
Phone (561) 792-7414

701 E 16th St
Berwick, PA 18603
Phone (570) 754-5000

Interoperability endpoints

  • Direct secure messaging: kris@gulfstreamanesthesia.com

Practitioners & affiliated clinicians

Practitioners 93

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 93

NPI Registry JSON

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

{
    "created_epoch": "1154563200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1651104000000",
    "number": "1992713242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 212110",
            "city": "ROYAL PALM BEACH",
            "state": "FL",
            "postal_code": "334212110",
            "telephone_number": "877-204-4155",
            "fax_number": "877-213-5232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "275 GUTHRIE DR",
            "city": "TROY",
            "state": "PA",
            "postal_code": "169478115",
            "telephone_number": "877-204-4155",
            "fax_number": "877-213-5232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GULFSTREAM ANESTHESIA CONSULTANTS PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-03",
        "last_updated": "2022-04-28",
        "certification_date": "2022-04-28",
        "status": "A",
        "authorized_official_last_name": "REID",
        "authorized_official_first_name": "LAWRENCE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "561-204-5230",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1012390590002",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1012390590001",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Kris@gulfstreamanesthesia.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "email",
            "address_1": "275 Guthrie Dr",
            "city": "Troy",
            "state": "PA",
            "country_code": "US",
            "postal_code": "169478115",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Troy, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2022; 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.