Individual provider Active NPI

Mary Anibuali, CRNA

  • Certified Registered Nurse Anesthetist
  • Fort Sam Houston, TX
National Provider Identifier
1124597000
Registry record updated Aug 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
1127831 Issued in TX
Practice address
3551 Roger Brooke Dr
Fort Sam Houston, TX 78234-4504
Phone
(210) 916-7500
NPI assigned
Nov 20, 2018
Last updated
Aug 20, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 20, 2024

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 1127831 TX Primary

Addresses

Primary practice location

3551 Roger Brooke Dr
Fort Sam Houston, TX 78234-4504

Mailing address

3551 Roger Brooke Dr
Fort Sam Houston, TX 78234-4504
Phone (210) 916-7500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV, TX2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20190129000630 WV Practitioner - Certified Registered Nurse Anesthetist (Crna) 3072850007 Reassigns benefits to 4 organizations
I20231116001609 TX Practitioner - Certified Registered Nurse Anesthetist (Crna) 3072850007 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Houston Anesthesia Services PLLCGroup PAC ID 6305255399, 27 clinicians
CPR Anesthesia IncGroup PAC ID 7416272927, 41 clinicians

Practice addresses (Care Compare)

6200 Savoy Dr
Suite 1202
Houston, TX 77036-3397
Phone (888) 589-8550

715 Camden St
San Antonio, TX 78215-1619
Phone (210) 226-6169

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1127831TXMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Charleston Area Medical Center, Inc. CurrentSince Feb 23, 2023 Accepting new patients
Houston Anesthesia Services PLLC CurrentSince Mar 1, 2025 Accepting new patients
Safe & Sound Anesthesia Services LLC Nurse Anesthetist, Certified Registered CurrentSince Jan 1, 2023 Accepting new patients
CPR Anesthesia, Inc Nurse Anesthetist, Certified Registered CurrentSince Dec 21, 2024 Accepting new patients
Appalachian Regional Healthcare, Inc. Nurse Anesthetist, Certified Registered CurrentSince Nov 1, 2019 Accepting new patients
Harris County Med Surg Partners PLLC CurrentSince Mar 1, 2025 Accepting new patients
Appalachian Regional Healthcare, Inc Current Accepting new patients
Austin Anesthesiology Group PLLC CurrentSince Oct 15, 2023 Accepting new patients
Charleston Area Medical Center Inc CurrentSince Feb 23, 2023 Accepting new patients
Austin Anesthesiology Group, PLLC Nurse Anesthetist, Certified Registered Current Accepting new patients
Medstream Anesthesia PLLC Nurse Anesthetist, Certified Registered CurrentSince Nov 26, 2018 Accepting new patients
Appalachian Regional Healthcare, Inc CurrentSince Nov 1, 2019 Accepting new patients

Locations

82 Patton Ave
Ste 510
Asheville, NC 28801
Phone (828) 210-9386

111 Town Square Pl
Ste 420
Jersey City, NJ 07310
Phone (201) 258-4700

1305 Walt Whitman Rd
Ste 300
Melville, NY 11747
Phone (516) 370-3796

6200 Savoy Dr
Ste 1202
Houston, TX 77036
Phone (254) 220-5560

1310 McCullough Ave
San Antonio, TX 78212
Phone (210) 208-2200

715 Camden St
San Antonio, TX 78215
Phone (210) 692-0218

17005 Interstate 35 N
Schertz, TX 78154

421 School St
Ste 110
Tomball, TX 77375
Phone (281) 357-1977

1710 Harper Rd
Beckley, WV 25801
Phone (304) 252-0641

306 Stanaford Rd
Beckley, WV 25801
Phone (304) 255-3373

84 Brookshire Ln
Beckley, WV 25801
Phone (304) 255-2341

501 Morris St
Charleston, WV 25301
Phone (304) 348-6293

Organizations & group practices 12

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.

NPI Registry JSON

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

{
    "created_epoch": "1542672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724112000000",
    "number": "1124597000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3551 ROGER BROOKE DR",
            "city": "FORT SAM HOUSTON",
            "state": "TX",
            "postal_code": "782344504",
            "telephone_number": "210-916-7500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3551 ROGER BROOKE DR",
            "city": "FORT SAM HOUSTON",
            "state": "TX",
            "postal_code": "782344504",
            "telephone_number": "210-916-7500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANIBUALI",
        "first_name": "MARY",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-11-20",
        "last_updated": "2024-08-20",
        "certification_date": "2024-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "1127831",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Sam Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2024; 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.