Individual provider Active NPI

Marvin Weiss, CRNA

  • Certified Registered Nurse Anesthetist
  • Houston, TX
National Provider Identifier
1124554340
Registry record updated Sep 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
AP135129 Issued in TX
Practice address
1500 Citywest Blvd Ste 300
Houston, TX 77042-2549
Phone
(976) 204-0713
Fax
(713) 458-4229
NPI assigned
May 8, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2021

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 635921 NY
Certified Registered Nurse Anesthetist 367500000X 11011475 FL
Certified Registered Nurse Anesthetist 367500000X 919662 TX
Certified Registered Nurse Anesthetist 367500000X AP135129 TX Primary

Addresses

Primary practice location

1500 Citywest Blvd Ste 300
Houston, TX 77042-2549

Mailing address

6780 Pershing St
Hollywood, FL 33024-1834
Phone (347) 254-4798

Other practice location 1

4725 N Federal Hwy
Fort Lauderdale, FL 33308-4603
Phone (954) 463-5271

Other practice location 2

2424 Kings Hwy
Apt 3A
Brooklyn, NY 11229-1669
Phone (347) 254-4798

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210716001883 FL Practitioner - Certified Registered Nurse Anesthetist (Crna) 8527333657 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sheridan Healthcorp IncGroup PAC ID 3173429693, 956 clinicians

Practice addresses (Care Compare)

201 E Sample Rd
Deerfield Beach, FL 33064-3502
Phone (954) 939-5000

Hospital & facility affiliations

  • Broward Health Medical Center Hospital, Fort Lauderdale, FL, CCN 100039

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
635921NYMDRegistered Nurse
11011475FLMDCertified Registered Nurse Anesthetist
919662TXMDCertified Registered Nurse Anesthetist
AP135129TXMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Anesco North Broward LLC CurrentSince Jul 1, 2024 Accepting new patients
American Anesthesiology of Florida, Inc Current Accepting new patients
Sheridan Healthcorp Inc Nurse Anesthetist, Certified Registered CurrentSince Mar 1, 2025 Accepting new patients
American Anesthesiology of Florida, Inc CurrentSince Jul 1, 2021 Accepting new patients
Sheridan Healthcorp Inc Nurse Anesthetist, Certified Registered Current Accepting new patients
American Anesthesiology Services of Florida, Inc. CurrentSince May 1, 2021 Accepting new patients

Locations

21644 State Road 7
Boca Raton, FL 33428
Phone (561) 488-8210

201 E Sample Rd
Deerfield Beach, FL 33064
Phone (954) 786-6400

3601 W Commercial Blvd
Ste 5
Ft Lauderdale, FL 33309
Phone (954) 485-2002

3601 W Commercial Blvd
Ste 4
Ft Lauderdale, FL 33309

4725 N Federal Hwy
Oakland Park, FL 33308
Phone (954) 493-5005

3501 Johnson St
Pembroke Park, FL 33021
Phone (954) 265-2000

Organizations & group practices 6

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 1

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": "1494201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632873600000",
    "number": "1124554340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6780 PERSHING ST",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330241834",
            "telephone_number": "347-254-4798"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 CITYWEST BLVD STE 300",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770422549",
            "telephone_number": "976-204-0713",
            "fax_number": "713-458-4229"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4725 N Federal Hwy",
            "address_purpose": "LOCATION",
            "city": "Fort Lauderdale",
            "state": "FL",
            "postal_code": "333084603",
            "country_code": "US",
            "telephone_number": "954-463-5271",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2424 Kings Hwy",
            "address_2": "Apt 3A",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112291669",
            "country_code": "US",
            "telephone_number": "347-254-4798",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WEISS",
        "first_name": "MARVIN",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-05-08",
        "last_updated": "2021-09-29",
        "certification_date": "2021-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "635921",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "11011475",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "919662",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "AP135129",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2021; 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.