Individual provider Active NPI

Mirasol Herbias Zalavarria, CRNA

  • Certified Registered Nurse Anesthetist
  • Houston, TX
National Provider Identifier
1174874952
Registry record updated May 21, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
731697 Issued in TX
Practice address
2411 Fountain View Dr
Ste. 200
Houston, TX 77057-4817
Phone
(713) 620-4000
NPI assigned
Sep 20, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 2013

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 731697 TX Primary

Addresses

Primary practice location

2411 Fountain View Dr
Ste. 200
Houston, TX 77057-4817

Mailing address

2411 Fountain View Dr
Ste. 200
Houston, TX 77057-4817
Phone (713) 620-4000

Other identifiers 4

IdentifierTypeStateIssuer
304459601MedicaidTX
P01163086OtherTXRAILROAD MEDICARE
307759602MedicaidTX
8465UDOtherTXBLUE CROSS BLUE SHIELD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121018000299 TX Practitioner - Certified Registered Nurse Anesthetist (Crna) 5395995807 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Texans Anesthesia Associates PLLCGroup PAC ID 8820171390, 197 clinicians

Practice addresses (Care Compare)

1635 N Loop W
Houston, TX 77008-1532
Phone (713) 400-2990

7401 Main St
Houston, TX 77030-4509
Phone (713) 400-2990

Hospital & facility affiliations

  • Texas Orthopedic Hospital Hospital, Houston, TX, CCN 450804

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
731697TXMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Texans Anesthesia Associates PLLC Nurse Anesthetist, Certified Registered CurrentSince Jan 1, 2015 Accepting new patients

Locations

1635 North Loop W
Houston, TX 77008
Phone (713) 867-2066

1631 North Loop W
Ste 300
Houston, TX 77008
Phone (713) 343-1080

4219 Richmond Ave
Ste 100
Houston, TX 77027
Phone (713) 634-4433

7700 Fannin St
Houston, TX 77054
Phone (713) 790-1349

333 N Texas Ave
Ste 1000
Webster, TX 77598
Phone (281) 557-5620

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 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": "1348099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1369094400000",
    "number": "1174874952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2411 FOUNTAIN VIEW DR",
            "address_2": "STE. 200",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770574817",
            "telephone_number": "713-620-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2411 FOUNTAIN VIEW DR",
            "address_2": "STE. 200",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770574817",
            "telephone_number": "713-620-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZALAVARRIA",
        "first_name": "MIRASOL",
        "middle_name": "HERBIAS",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-20",
        "last_updated": "2013-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "731697",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "304459601",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P01163086",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "307759602",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "8465UD",
            "state": "TX"
        }
    ],
    "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 May 21, 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.