MEDICARE: OUTPATIENT ANESTHESIA SPECIALISTS LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207L00000X	Anesthesiology Physician
2	367500000X	Certified Registered Nurse Anesthetist

General Provider Information

NPI Number	:	1194828673
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OUTPATIENT ANESTHESIA SPECIALISTS LLC

Provider Business Mailing Address
First Line	:	701 E 101ST TER
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64131-4271
Country	:	US
Telephone Number	:	479-925-8914
Fax Number	:	314-821-1833

Provider Business Practice Location Address
First Line	:	701 E 101ST TER
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64131-4271
Country	:	US
Telephone Number	:	479-925-8914
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	JONAH GARRETT
Credential	:	MD
Telephone Number	:	479-925-8914

Provider Enumeration Date	:	09/07/2006
Last Update Date	:	12/03/2025

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