Individual provider Active NPI

Thomas J Fernandez, CRNA

  • Certified Registered Nurse Anesthetist
  • Dallas, TX
National Provider Identifier
1043211832
Registry record updated Jul 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
AP109111 Issued in TX
Practice address
12222 Merit Dr Ste 600
Dallas, TX 75251-3294
Phone
(972) 715-5000
Fax
(972) 715-9976
NPI assigned
Aug 3, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2022

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 0024161198 VA
Certified Registered Nurse Anesthetist 367500000X NA04692 OH
Certified Registered Nurse Anesthetist 367500000X ARNP3370282 FL
Certified Registered Nurse Anesthetist 367500000X AP109111 TX Primary
Certified Registered Nurse Anesthetist 367500000X RN336267-L PA
Certified Registered Nurse Anesthetist 367500000X 55673 WV

Addresses

Primary practice location

12222 Merit Dr Ste 600
Dallas, TX 75251-3294

Mailing address

PO Box 840853
Dallas, TX 75284-1003
Phone (972) 233-1999

Other practice location 1

1400 NW 12th Ave
Miami, FL 33136-1003
Phone (305) 243-6358

Other identifiers 5

IdentifierTypeStateIssuer
0069685000MedicaidWV
000000679153OtherOHANTHEM
000000679191OtherOHANTHEM
2698693MedicaidOH
07537583MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, MI, TX, IN, KS, FL, NM, GA, SC, KY, AZ, OK, NE, WI, PA15 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 15

Enrollment IDStateProvider typePAC IDDetails
I20040525001125 NC Practitioner - Certified Registered Nurse Anesthetist (Crna) 5698756831 Reassigns benefits to 1 organization
I20060207000258 MI Practitioner - Certified Registered Nurse Anesthetist (Crna) 5698756831 Reassigns benefits to 1 organization
I20100428000870 TX Practitioner - Certified Registered Nurse Anesthetist (Crna) 5698756831 Reassigns benefits to 2 organizations
I20130301000285 IN Practitioner - Certified Registered Nurse Anesthetist (Crna) 5698756831 Reassigns benefits to 1 organization
I20131015002171 KS Practitioner - Certified Registered Nurse Anesthetist (Crna) 5698756831 Reassigns benefits to 2 organizations
I20140324001723 FL Practitioner - Certified Registered Nurse Anesthetist (Crna) 5698756831 Reassigns benefits to 1 organization
I20140929000273 NM Practitioner - Certified Registered Nurse Anesthetist (Crna) 5698756831 Reassigns benefits to 1 organization
I20150414001321 GA Practitioner - Certified Registered Nurse Anesthetist (Crna) 5698756831 Reassigns benefits to 1 organization
I20151012002453 SC Practitioner - Certified Nurse Midwife (CNM) 5698756831 Reassigns benefits to 1 organization
I20170310002133 KY Practitioner - Certified Registered Nurse Anesthetist (Crna) 5698756831 Reassigns benefits to 1 organization
I20220808001383 AZ Practitioner - Certified Registered Nurse Anesthetist (Crna) 5698756831 Reassigns benefits to 1 organization
I20231121002105 OK Practitioner - Certified Registered Nurse Anesthetist (Crna) 5698756831 Reassigns benefits to 1 organization
I20240618004029 NE Practitioner - Certified Registered Nurse Anesthetist (Crna) 5698756831 Reassigns benefits to 1 organization
I20240620000958 WI Practitioner - Certified Registered Nurse Anesthetist (Crna) 5698756831 Reassigns benefits to 1 organization
I20250715003678 PA Practitioner - Certified Registered Nurse Anesthetist (Crna) 5698756831 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
360 Anesthesia PLLCGroup PAC ID 5991184863, 112 clinicians

Practice addresses (Care Compare)

575 N River St
Wilkes Barre, PA 18764-0999
Phone (570) 829-8111

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
ARNP3370282FLMDCertified Registered Nurse Anesthetist
NA04692OHMDCertified Registered Nurse Anesthetist
RN336267-LPAMDCertified Registered Nurse Anesthetist
AP109111TXMDCertified Registered Nurse Anesthetist
0024161198VAMDCertified Registered Nurse Anesthetist
55673WVMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Columbus Community Hospital Inc CurrentSince Jun 24, 2024 Accepting new patients
Mercy Health System Corporation CurrentSince Jun 3, 2024 Accepting new patients
Emergenchealth PLLC Nurse Anesthetist, Certified Registered CurrentSince Aug 15, 2022 Accepting new patients
Anesthesia Consultants PA CurrentSince Sep 1, 2016 Accepting new patients
Mercy Health System Corporation CurrentSince Jun 3, 2024 Accepting new patients
Mercy Health System Corporation Current Accepting new patients
Universal Anesthesia Services LLC Nurse Anesthetist, Certified Registered CurrentSince Jun 1, 2020 Accepting new patients
Northstar Anesthesia of Indiana LLC Nurse Anesthetist, Certified Registered CurrentSince Nov 19, 2012 Accepting new patients
Resource Anesthesiology Associates of NM Inc CurrentSince Sep 22, 2014 Accepting new patients
Saginaw Anesthesia Services, PLLC CurrentSince Nov 10, 2022 Accepting new patients
Columbus Community Hospital Inc Nurse Anesthetist, Certified Registered CurrentSince Jun 24, 2024 Accepting new patients
Western Oklahoma Anesthesia Consultants PLLC CurrentSince Sep 23, 2023 Accepting new patients
Valley Anesthesiology Consultants, Inc. CurrentSince Aug 1, 2022 Accepting new patients
Sweet Dreams Nurse Anesthesia, Inc. Nurse Anesthetist, Certified Registered CurrentSince Jan 9, 2015 Accepting new patients
Center for Pain Relief, Inc. Physical Therapist Past Accepting new patients
Uniontown Anesthesia Associates, LTD Past Accepting new patients
Milford Anesthesia Associates LLC Nurse Anesthetist, Certified Registered PastSince Sep 25, 2019 Accepting new patients
Anesthesia Network Services, LLC Past Accepting new patients
Professional Anesthesia Service,Inc. Past Accepting new patients
Grady Anesthesia Services, Inc Past Accepting new patients
Sheridan Healthcare of West Virginia Inc Nurse Anesthetist, Certified Registered PastSince May 21, 2023 Accepting new patients
Pittsburgh Anesthesia Associates, LTD. Past Accepting new patients
Western Pennsylvania Anesthesia Associates, LTD. Past Accepting new patients
Columbia-St Josephs Heathcare System Limited Partnership Past Accepting new patients
SJH Services Aa Inc Past Accepting new patients
Nurse Anesthesia of North Carolina, PLLC Nurse Anesthetist, Certified Registered Past Accepting new patients

Locations (25 of 30)

5880 S Hospital Dr
Globe, AZ 85501
Phone (928) 402-1217

1500 S Dobson Rd
Ste 101
Mesa, AZ 85202
Phone (480) 306-6098

1850 N Central Ave
Ste 1600
Phoenix, AZ 85004
Phone (602) 744-4760

645 E Missouri Ave
Ste 300
Phoenix, AZ 85012
Phone (602) 262-8917

1601 W Saint Marys Rd
Tucson, AZ 85745
Phone (520) 622-5833

3625 University Blvd S
Jacksonville, FL 32216
Phone (904) 333-9404

117 Kite Rd
Swainsboro, GA 30401
Phone (248) 972-8725

29624 Network Pl
Chicago, IL 60673
Phone (608) 741-7652

3423 Solutions Ctr
Chicago, IL 60677

24 Joliet St
Dyer, IN 46311
Phone (219) 864-2237

701 Superior Ave
Munster, IN 46321
Phone (219) 922-4200

200 E Chestnut St
Louisville, KY 40202
Phone (502) 446-8000

500 Campus Dr
Hancock, MI 49930
Phone (906) 483-1000

1447 N Harrison St
Saginaw, MI 48602
Phone (989) 583-4220

700 Cooper Ave
Saginaw, MI 48602
Phone (989) 583-6000

4600 38th St
Columbus, NE 68601
Phone (402) 562-3333

2450 S Telshor Blvd
Las Cruces, NM 88011
Phone (505) 522-8641

430 N Monte Vista St
Ada, OK 74820
Phone (580) 226-1251

1800 Renaissance Blvd
Edmond, OK 73013
Phone (405) 359-2400

1801 W 3rd St
Elk City, OK 73644
Phone 5802255403677

1710 W 3rd St
Ste 100
Elk City, OK 73644
Phone (580) 255-1555

4 E Clark Bass Blvd
McAlester, OK 74501
Phone (918) 421-6700

1 E Clark Bass Blvd
McAlester, OK 74501
Phone (918) 421-6941

401 SW 80th St
Ste 200
Oklahoma City, OK 73139
Phone (405) 601-4227

3701 E Main St
Weatherford, OK 73096
Phone (580) 772-5551

Organizations & group practices 30

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.

View all 30

Hospital & facility affiliations 4

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": "1123027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659052800000",
    "number": "1043211832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 840853",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752841003",
            "telephone_number": "972-233-1999",
            "fax_number": "972-233-3666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12222 MERIT DR STE 600",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752513294",
            "telephone_number": "972-715-5000",
            "fax_number": "972-715-9976"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1400 NW 12th Ave",
            "address_purpose": "LOCATION",
            "city": "Miami",
            "state": "FL",
            "postal_code": "331361003",
            "country_code": "US",
            "telephone_number": "305-243-6358",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FERNANDEZ",
        "first_name": "THOMAS",
        "middle_name": "J",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-03",
        "last_updated": "2022-07-29",
        "certification_date": "2022-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "VA",
            "license": "0024161198",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "OH",
            "license": "NA04692",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "ARNP3370282",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "AP109111",
            "primary": true
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "PA",
            "license": "RN336267-L",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "WV",
            "license": "55673",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0069685000",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000679153",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000679191",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2698693",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "07537583",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.