ANESTHESIA GROUP PRACTICE, INC – Anesthesiology Physician, NPI 1417951948
Anesthesiology Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for ANESTHESIA GROUP PRACTICE, INC
Boom Box Buns, 1324, Main Street, Main Street Business District, Over-the-Rhine, Cincinnati, Hamilton County, Ohio, 45202, United States
CINCINNATI, OH 452632572
Phone: (859) 341-2666
Fax: (513) 351-0316
Type: Mailing
Montgomery Road, O’Bryonville, Evanston, Cincinnati, Hamilton County, Ohio, 45207, United States
CINCINNATI, OH 452424402
Phone: (513) 817-1150
Fax: (513) 895-9124
Type: Location
10500 MONTGOMERY RD
MONTGOMERY, OH 452424402
Phone: (513) 817-1150
Fax: (513) 351-0316
Type: Location
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: 2019-04-11
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Past revalidation due date
Earliest CMS due date was 2024-06-30 (710 days ago).
Enrollment records
3
Earliest due date
2024-06-30
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 |
|---|---|---|---|---|
| O20031114000492 | O | Clinic/Group Practice | OH | 2025-09-30 |
| O20151204001398 | O | Clinic/Group Practice | KY | TBD |
| O20190411002313 | O | Clinic/Group Practice | IN | 2024-06-30 |
What to do next
- Verify current status on the CMS Revalidation Lookup Tool immediately.
- Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
- Overdue revalidation can lead to deactivation of Medicare billing privileges.
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 45263)
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