PREMIER ANESTHESIA OF MONTGOMERY PC – Anesthesiology Physician, NPI 1780636233
Anesthesiology Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for PREMIER ANESTHESIA OF MONTGOMERY PC
400 Taylor Rd
Montgomery, AL 361173512
Phone: (404) 941-1210
Fax: (404) 941-1264
Type: Location
124 S Memorial Dr
Prattville, AL 360673619
Phone: (404) 941-1210
Fax: (404) 941-1264
Type: Location
Baptist Medical Center South, 2105, East South Boulevard, Governors Estates, Montgomery, Montgomery County, Alabama, 36116, United States
MONTGOMERY, AL 36116
Phone: (770) 643-5500
Fax: (404) 941-1304
Type: Location
470 Taylor Rd Ste 100
Montgomery, AL 361173532
Phone: (334) 290-4530
Type: Location
2655, Northwinds Parkway, Alpharetta, Fulton County, Georgia, 30009, United States
ALPHARETTA, GA 300092280
Phone: (855) 220-3662
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
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: 2004-01-05
PECOS data refreshed: 2026-05-27
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 |
|---|---|---|---|---|
| O20040105000491 | O | Clinic/Group Practice | AL | 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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 36117)
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