Individual provider Active NPI

Tesfay K Gselassie, CRNA

  • Certified Registered Nurse Anesthetist
  • Dallas, TX
National Provider Identifier
1144219866
Registry record updated Mar 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
587747 Issued in TX
Practice address
13601 Preston Rd
Ste 1000W
Dallas, TX 75240-4911
Phone
(972) 663-8523
Fax
(972) 663-8329
NPI assigned
Oct 15, 2005
Last updated
Mar 4, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 587747 TX Primary
Registered Nurse 163W00000X RN 210348 OH

Addresses

Primary practice location

13601 Preston Rd
Ste 1000W
Dallas, TX 75240-4911

Mailing address

PO Box 650426
Dallas, TX 75265-0426
Phone (972) 715-5000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130429000601 TX Practitioner - Certified Registered Nurse Anesthetist (Crna) 2062658529 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
88.94 of 100Reported as group
Quality
91.31
Improvement activities
40
Cost
79.05

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN 210348OHMDRegistered Nurse
587747TXMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Palo Pinto County Hospital District Current Accepting new patients
Palo Pinto County Hospital District CurrentSince Dec 14, 2015 Accepting new patients
Anesthesia of North Texas, PA Nurse Anesthetist, Certified Registered CurrentSince Jan 1, 2015 Accepting new patients
Palo Pinto County Hospital District Nurse Anesthetist, Certified Registered CurrentSince Dec 14, 2015 Accepting new patients
Palo Pinto County Hospital District Current Accepting new patients

Locations

1001 N Waldrop Dr
Ste 701
Arlington, TX 76012
Phone (817) 265-4844

400 SW 25th Ave
Mineral Wells, TX 76067
Phone (940) 325-7891

Organizations & group practices 5

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": "1129334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1362355200000",
    "number": "1144219866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 650426",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752650426",
            "telephone_number": "972-715-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13601 PRESTON RD",
            "address_2": "STE 1000W",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752404911",
            "telephone_number": "972-663-8523",
            "fax_number": "972-663-8329"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GSELASSIE",
        "first_name": "TESFAY",
        "middle_name": "K",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-15",
        "last_updated": "2013-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "587747",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OH",
            "license": "RN 210348",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2013; 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.