Individual provider Active NPI

Michael Charles Holub, M.D.

  • Anesthesiology Physician
  • Dallas, TX
National Provider Identifier
1174500524
Registry record updated Mar 6, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
J8583 Issued in TX
Practice address
8200 Walnut Hill LN
Dallas, TX 75231-4426
Phone
(214) 345-6148
Fax
(214) 345-4322
NPI assigned
Dec 28, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X J8583 TX Primary

Addresses

Primary practice location

8200 Walnut Hill LN
Dallas, TX 75231-4426

Mailing address

13601 Preston Rd
Suite 900W
Dallas, TX 75240-4911
Phone (972) 233-1999

Other identifiers 3

IdentifierTypeStateIssuer
118200803MedicaidTX
83789KOtherTXBCBS
118200802MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100831000328 TX Practitioner - Anesthesiology 0143344903 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
University of Texas Southwestern Medical School at Dallas, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anesthesia Partners of Dallas PLLCGroup PAC ID 7810293438, 21 clinicians

Practice addresses (Care Compare)

8200 Walnut Hill LN
Dallas, TX 75231-4402
Phone (214) 345-6789

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesia Partners of Dallas PLLC Anesthesiology CurrentSince Apr 1, 2016 Accepting new patients

Locations

8200 Walnut Hill Ln
Dallas, TX 75231
Phone (214) 345-6148

14850 Quorum Dr
Ste 400
Dallas, TX 75254
Phone (214) 801-1879

8200 Walnut Hill Ln
#D
Dallas, TX 75231
Phone (214) 345-5634

2221 Lakeside Blvd
Ste 600
Richardson, TX 75082
Phone (469) 998-7450

Interoperability endpoints

  • Direct secure messaging: mholub@direct.uspi.com

Organizations & group practices 1

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.

Hospital & facility affiliations 2

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": "1135728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1236297600000",
    "number": "1174500524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13601 PRESTON RD",
            "address_2": "SUITE 900W",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752404911",
            "telephone_number": "972-233-1999",
            "fax_number": "972-386-4292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8200 WALNUT HILL LN",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752314426",
            "telephone_number": "214-345-6148",
            "fax_number": "214-345-4322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLUB",
        "first_name": "MICHAEL",
        "middle_name": "CHARLES",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-28",
        "last_updated": "2009-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "TX",
            "license": "J8583",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "118200803",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "83789K",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "118200802",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.