Koalat Anesthesia PLLC

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

Legal business name

KOALAT ANESTHESIA PLLC

Practice address

19010 Stone Oak Pkwy
San Antonio, TX 78258-3225

Phone

(210) 575-5200

NPI assigned

Oct 31, 2022

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Melissa Ann Waterman, CRNANPI 1013346733

Title

Crna, Owner

Phone

(325) 660-5535

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Melissa Ann Waterman, RN, CRNA

  • Certified Registered Nurse Anesthetist
  • Jbsa Ft Sam Houston, TX
  • NPI 1013346733

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD Authorized official
• Brent Duffield, CRNA

  • Certified Registered Nurse Anesthetist
  • San Antonio, TX
  • NPI 1013439611

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1667174400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1671580800000",
    "number": "1003523192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3301 S 14TH ST STE 16180",
            "city": "ABILENE",
            "state": "TX",
            "postal_code": "796055015",
            "telephone_number": "325-660-5535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19010 STONE OAK PKWY",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782583225",
            "telephone_number": "210-575-5200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5255 Prue Rd Ste 100",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "782401335",
            "country_code": "US",
            "telephone_number": "210-614-6059",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "KOALAT ANESTHESIA PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-31",
        "last_updated": "2022-12-21",
        "certification_date": "2022-12-21",
        "status": "A",
        "authorized_official_last_name": "WATERMAN",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "CRNA, OWNER",
        "authorized_official_telephone_number": "325-660-5535",
        "authorized_official_credential": "CRNA"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Flora Knudtson, M.D.
• Edel Aleen Knutsen-Philippi, LPC
• Molly E Knutson, CD
• Timothy Lawrence Knutson, D.P.M.
• Heidi Chwan Ko, D.O.
• Ayumi Kobayashi
• Beth Kobb, LCSW
• Joseph Kobos, PHD
• Allen Marvin Kobrin, OTR/L
• Barbara Koch

• Certified Registered Nurse Anesthetist in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Certified Registered Nurse Anesthetist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.