Individual provider Active NPI

Honey Mae Baldoza Doctolero, CRNA

  • Certified Registered Nurse Anesthetist
  • Galveston, TX
National Provider Identifier
1003976168
Registry record updated Jan 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
621160 Issued in TX
Practice address
301 University Blvd
Galveston, TX 77555-1022
Phone
(409) 747-0890
Fax
(409) 772-0885
NPI assigned
Dec 11, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 621160 TX Primary

Addresses

Primary practice location

301 University Blvd
Galveston, TX 77555-1022

Mailing address

301 University Blvd
Galveston, TX 77555-1022
Phone (409) 747-0890

Other identifiers 1

IdentifierTypeStateIssuer
165625801MedicaidTX

Other names 1

  • Honey Mae Baldoza Doctolero Professional name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mae.doctolero@direct.myteamcare.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040408000560 TX Practitioner - Certified Registered Nurse Anesthetist (Crna) 7012900582 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

3601 4TH St
1B350K
Lubbock, TX 79430-8182
Phone (806) 743-2981

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
99.52 of 100Reported as apm
Quality
87.98
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
621160TXMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Tech University Health Sciences Center Lubbock Current Accepting new patients
Texas Tech University Health Sciences Center Lubbock CurrentSince Mar 15, 2007 Accepting new patients
Texas Tech University Health Sciences Center Lubbock CurrentSince Mar 15, 2007 Accepting new patients
Texas Tech University Health Sciences Center Lubbock Past Accepting new patients
Utmb Faculty Group Practice Past Accepting new patients

Locations

3601 4th St
#1B350K
Lubbock, TX 79430
Phone (806) 743-2981

602 Indiana Ave
Lubbock, TX 79415
Phone (806) 743-2898

3601 4th St
Lubbock, TX 79430
Phone (806) 743-1000

Interoperability endpoints

  • Direct secure messaging: mae.doctolero@direct.myteamcare.com

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642550400000",
    "number": "1003976168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 UNIVERSITY BLVD",
            "city": "GALVESTON",
            "state": "TX",
            "postal_code": "775551022",
            "telephone_number": "409-747-0890",
            "fax_number": "409-772-0885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 UNIVERSITY BLVD",
            "city": "GALVESTON",
            "state": "TX",
            "postal_code": "775551022",
            "telephone_number": "409-747-0890",
            "fax_number": "409-772-0885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOCTOLERO",
        "first_name": "HONEY",
        "middle_name": "MAE BALDOZA",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-11",
        "last_updated": "2022-01-19",
        "certification_date": "2022-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "621160",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "165625801",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mae.doctolero@direct.myteamcare.com",
            "affiliation": "N",
            "address_1": "3601 4th St",
            "city": "Lubbock",
            "state": "TX",
            "country_code": "US",
            "postal_code": "794300002",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "HONEY",
            "last_name": "DOCTOLERO",
            "middle_name": "MAE BALDOZA",
            "credential": "CRNA",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Galveston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.