Provider Demographics
NPI:1033160452
Name:ANESTHESIA CARE ASSOCIATES, PC
Entity Type:Organization
Organization Name:ANESTHESIA CARE ASSOCIATES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:STUART
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:800-516-5315
Mailing Address - Street 1:PO BOX 853
Mailing Address - Street 2:
Mailing Address - City:PALMER
Mailing Address - State:AK
Mailing Address - Zip Code:99645-0853
Mailing Address - Country:US
Mailing Address - Phone:800-516-5315
Mailing Address - Fax:907-745-0200
Practice Address - Street 1:2500 S WOODWORTH LOOP
Practice Address - Street 2:
Practice Address - City:PALMER
Practice Address - State:AK
Practice Address - Zip Code:99645-8984
Practice Address - Country:US
Practice Address - Phone:907-745-0374
Practice Address - Fax:907-745-0200
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-12
Last Update Date:2019-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKMD0271Medicaid
AK193975000OtherGROUP FEDERAL DOL#
AKMDG417Medicaid
AKMD01001Medicaid
AK050067816OtherKOEHRER RAILROAD MCR#
AKMD02651Medicaid
AKCI9459OtherGROUP RAILROAD MCR#
AK020257499OtherGROUP DEPT OF LABOR#
AKMD1730Medicaid
AKMD0638Medicaid
AK050067817OtherLEE RAILROAD MCR#
AK020257499OtherGROUP DEPT OF LABOR#
AK151373Medicare ID - Type UnspecifiedCLOUGH ID#
AK152642Medicare ID - Type UnspecifiedJENSEN ID#
AKMD02651Medicaid
AKMD0271Medicaid
AKMD0638Medicaid
AK193975000OtherGROUP FEDERAL DOL#
AKCI9459OtherGROUP RAILROAD MCR#