Individual provider Active NPI

Elisabeth Dillon

  • Certified Registered Nurse Anesthetist
  • San Antonio, TX
National Provider Identifier
1164754594
Registry record updated Feb 10, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
660893 Issued in TX
Practice address
13102 Maple Park Dr
San Antonio, TX 78249-3628
Phone
(013) 022-2506
NPI assigned
Feb 10, 2010
Last updated
Feb 10, 2010By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 10, 2010

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 660893 TX Primary
Registered Nurse 163W00000X 660893 TX

Addresses

Primary practice location

13102 Maple Park Dr
San Antonio, TX 78249-3628

Mailing address

65TH Med Bde
Box 775
Apo, AP 96205

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220711001169 TX Practitioner - Certified Registered Nurse Anesthetist (Crna) 7810321494 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
660893TXMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Houston Anesthesia Services PLLC CurrentSince Aug 22, 2024 Accepting new patients
Austin Gastroenterology Anesthesia Associates PLLC Nurse Anesthetist, Certified Registered CurrentSince Apr 1, 2025 Accepting new patients

Locations

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

8015 Shoal Creek Blvd
Ste 300
Austin, TX 78757
Phone (512) 371-1519

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

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.

NPI Registry JSON

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

{
    "created_epoch": "1265760000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1265760000000",
    "number": "1164754594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "MIL",
            "address_1": "65TH MED BDE",
            "address_2": "BOX 775",
            "city": "APO",
            "state": "AP",
            "postal_code": "96205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13102 MAPLE PARK DR",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782493628",
            "telephone_number": "013-022-2506"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DILLON",
        "first_name": "ELISABETH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-02-10",
        "last_updated": "2010-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "660893",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TX",
            "license": "660893",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2010; 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.