Provider Demographics
NPI:1861450751
Name:KEYSTONE ANESTHESIA CONSULTANTS, LTD
Entity Type:Organization
Organization Name:KEYSTONE ANESTHESIA CONSULTANTS, LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:MASSUCCI
Authorized Official - Suffix:
Authorized Official - Credentials:M,D
Authorized Official - Phone:412-942-5786
Mailing Address - Street 1:2000 OXFORD DR
Mailing Address - Street 2:SUITE 303
Mailing Address - City:BETHEL PARK
Mailing Address - State:PA
Mailing Address - Zip Code:15102-1827
Mailing Address - Country:US
Mailing Address - Phone:412-942-5786
Mailing Address - Fax:
Practice Address - Street 1:80 LANDINGS DR STE 202
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:PA
Practice Address - Zip Code:15301-9408
Practice Address - Country:US
Practice Address - Phone:724-969-0191
Practice Address - Fax:724-941-9089
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-02
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty
No208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain MedicineGroup - Multi-Specialty
No208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA009769480004Medicaid
PA009769480004Medicaid
PA109876FG3Medicare UPIN