Unknown Individual – Anesthesiology Physician, NPI 1790743250
Anesthesiology Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
6,391 ANESTHESIOLOGY in CA
Loading map...
Provider Addresses for Unknown Individual
Stockton Post Office, 401, North San Joaquin Street, Stockton, San Joaquin County, California, 95202, United States
STOCKTON, CA 95267
Phone: (209) 956-7725
Fax: (209) 956-7733
Type: Mailing
13th Street, Los Banos, Merced County, California, 93635, United States
MERCED, CA 953406211
Phone: (209) 385-7087
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
Loading prescription activity...
Open Payments (CMS)
CMS reports 4 Open Payments records for all available years, with a total value of $2,012.
Total Amount is formed as General ($2,012) + Research ($0) + Ownership ($0) = $2,012.
Last reported payment date: 2024-04-14 • Largest payer in this snapshot: Nevro Corp. ($2,012).
Total Amount
$2,012
General + Research + Ownership
Payments
4
Total payment records
General Amount
$2,012
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-04-14
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Nevro Corp. | $2,012 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2004-11-24
PECOS data refreshed: 2026-06-15
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20041124000929 | I | Anesthesiology | CA | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 00790 | Anesthesia for other procedure on upper abdomen | 21 | 20 | $0 |
| 01402 | Anesthesia for procedure for total knee joint replacement | 18 | 17 | $0 |
| 64488 | Injection of local anesthetic for abdominal wall pain control on both sides using imaging guidance | 14 | 14 | $0 |
Insurance plans in this area (ZIP 95267)
Loading plans...
Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| ANESTHESIOLOGY | CA | 00142 | Anesthesia for lens surgery | 14 | 14 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| Certified Registered Nurse Anesthetist (Crna) | CA | |
| A N E S T H E S I O L O G Y | CA | |
| Pain Management, Anesthesiology, Addiction Medicine | NV | |
| Certified Registered Nurse Anesthetist (Crna) | CA | |
| A N E S T H E S I O L O G Y | NY | |
| Certified Registered Nurse Anesthetist (Crna) | CA | |
| A N E S T H E S I O L O G Y | CA | |
| A N E S T H E S I O L O G Y | CA | |
| Certified Registered Nurse Anesthetist (Crna) | CA | |
| Certified Registered Nurse Anesthetist (Crna) | CA |
Reviews
All reviews are moderated before publication. Reviews reflect users' opinions; we do not verify the accuracy of individual reviews.
No reviews yet. Be the first to share your experience — your opinion helps families compare providers.