NPIMap

Organization Active NPI

Illume Anesthesia PLLC

  • Certified Registered Nurse Anesthetist
  • Frisco, TX
National Provider Identifier
1114625902
Registry record updated Apr 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
Legal business name
ILLUME ANESTHESIA PLLC
Practice address
3140 Legacy Dr Ste 210
Frisco, TX 75034-7961
Phone
(469) 234-8888
NPI assigned
Feb 21, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2026

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

Authorized official

Name
Momin ZafarullahNPI 1316386055
Title
Owner/Auth Official
Phone
(210) 862-4199

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse AnesthetistGroup: 193400000X SINGLE SPECIALTY GROUP 367500000X Primary

Addresses

Primary practice location

3140 Legacy Dr Ste 210
Frisco, TX 75034-7961

Mailing address

PO Box 1889
Muncie, IN 47308-1889
Phone (765) 284-0493

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230427002022 TX Part B Supplier - Clinic/Group Practice 5991160863 Receives reassigned benefits from 21 practitioners
Practice locations: Frisco, TX; Plano, TX; McKinney, TX; Arlington, TX; Anna, TX

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 21

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

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1676937600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1775433600000",
    "number": "1114625902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1889",
            "city": "MUNCIE",
            "state": "IN",
            "postal_code": "473081889",
            "telephone_number": "765-284-0493"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3140 LEGACY DR STE 210",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "750347961",
            "telephone_number": "469-234-8888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ILLUME ANESTHESIA PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-02-21",
        "last_updated": "2026-04-06",
        "certification_date": "2026-04-06",
        "status": "A",
        "authorized_official_last_name": "ZAFARULLAH",
        "authorized_official_first_name": "MOMIN",
        "authorized_official_title_or_position": "OWNER/AUTH OFFICIAL",
        "authorized_official_telephone_number": "210-862-4199"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Frisco, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2026; 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.