Individual provider Active NPI

Max T Green, CRNA

  • Certified Registered Nurse Anesthetist
  • Bryan, TX
National Provider Identifier
1063698942
Registry record updated Sep 2, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
079088 Issued in TX
Practice address
1737 Briarcrest Dr
Suite 14
Bryan, TX 77802-2769
Phone
(979) 776-4777
Fax
(979) 776-0588
NPI assigned
Jan 10, 2008
Last updated
Sep 2, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2008

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 079088 TX Primary

Addresses

Primary practice location

1737 Briarcrest Dr
Suite 14
Bryan, TX 77802-2769

Mailing address

1737 Briarcrest Dr
Suite 14
Bryan, TX 77802-2769
Phone (979) 776-4777

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080619000015 TX Practitioner - Certified Registered Nurse Anesthetist (Crna) 9931270931 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Austin Anesthesiology Group PLLCGroup PAC ID 0547256497, 430 clinicians

Practice addresses (Care Compare)

2801 Franciscan Dr
Bryan, TX 77802-2544
Phone (979) 776-3777

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
079088TXMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Austin Anesthesiology Group PLLC CurrentSince May 4, 2012 Accepting new patients
Austin Anesthesiology Group, PLLC Nurse Anesthetist, Certified Registered Current Accepting new patients

Locations

1737 Briarcrest Dr
Ste 14
Bryan, TX 77802
Phone (409) 776-4777

2801 Franciscan Dr
Bryan, TX 77802
Phone (409) 776-3777

Organizations & group practices 2

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

Hospital & facility affiliations 2

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": "1199923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1220313600000",
    "number": "1063698942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1737 BRIARCREST DR",
            "address_2": "SUITE 14",
            "city": "BRYAN",
            "state": "TX",
            "postal_code": "778022769",
            "telephone_number": "979-776-4777",
            "fax_number": "979-776-0588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1737 BRIARCREST DR",
            "address_2": "SUITE 14",
            "city": "BRYAN",
            "state": "TX",
            "postal_code": "778022769",
            "telephone_number": "979-776-4777",
            "fax_number": "979-776-0588"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "MAX",
        "middle_name": "T",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-01-10",
        "last_updated": "2008-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "079088",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bryan, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2008; 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.