Individual provider Active NPI

Mary Amanda Theiss

  • Certified Registered Nurse Anesthetist
  • Fair Oaks Ranch, TX
National Provider Identifier
1215536586
Registry record updated May 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
1030889 Issued in TX
Practice address
8434 Raintree Woods Dr
Fair Oaks Ranch, TX 78015-4437
Phone
(318) 376-3819
NPI assigned
Oct 19, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 23, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 879598 TX
Certified Registered Nurse Anesthetist 367500000X 1030889 TX Primary

Addresses

Primary practice location

8434 Raintree Woods Dr
Fair Oaks Ranch, TX 78015-4437

Mailing address

8434 Raintree Woods Dr
Fair Oaks Ranch, TX 78015-4437
Phone (318) 376-3819

Other practice location 1

4502 Medical Dr
San Antonio, TX 78229-4402
Phone (210) 358-4000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210303000362 TX Practitioner - Certified Registered Nurse Anesthetist (Crna) 0042626871 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Medicine AssociatesGroup PAC ID 7719979509, 590 clinicians

Practice addresses (Care Compare)

4502 Medical Dr
San Antonio, TX 78229-4402
Phone (210) 358-2015

Hospital & facility affiliations

  • University Health System Hospital, San Antonio, TX, CCN 450213

Merit-based Incentive Payment System (MIPS)

Final score
96.65 of 100Reported as group
Quality
83.62
Promoting interoperability
100
Improvement activities
40
Cost
78.03

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
879598TXMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Youngs Professional Services LLC Nurse Anesthetist, Certified Registered CurrentSince Aug 10, 2022 Accepting new patients
University of Texas Health Science Center at San Antonio CurrentSince Mar 1, 2021 Accepting new patients
Community Medicine Associates CurrentSince Feb 15, 2023 Accepting new patients
Emergenchealth PLLC Nurse Anesthetist, Certified Registered CurrentSince Aug 10, 2022 Accepting new patients
The University of Texas Health Science Center at San Antonio CurrentSince Mar 1, 2021 Accepting new patients

Locations

903 W Martin St
#492
San Antonio, TX 78207
Phone (210) 358-3441

4940 Charles Katz
Fl 4
San Antonio, TX 78229
Phone (210) 450-9700

7703 Floyd Curl Dr
San Antonio, TX 78229
Phone (210) 450-3700

5255 Prue Rd
Ste 100
San Antonio, TX 78240
Phone (210) 384-2129

11212 State Highway 151
San Antonio, TX 78251
Phone (210) 281-5066

8300 Floyd Curl Dr
Fl 6
San Antonio, TX 78229
Phone (210) 450-9400

7400 Barlite Blvd
San Antonio, TX 78224
Phone (210) 921-2000

8300 Floyd Curl Dr
Fl 5
San Antonio, TX 78229
Phone (210) 450-9500

4502 Medical Dr
San Antonio, TX 78229
Phone (210) 358-3555

903 W Martin St
San Antonio, TX 78207
Phone (210) 358-3400

1305 Wonder World Dr
Ste 105
San Marcos, TX 78666
Phone (512) 353-8161

Organizations & group practices 6

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": "1603065600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716422400000",
    "number": "1215536586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8434 RAINTREE WOODS DR",
            "city": "FAIR OAKS RANCH",
            "state": "TX",
            "postal_code": "780154437",
            "telephone_number": "318-376-3819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8434 RAINTREE WOODS DR",
            "city": "FAIR OAKS RANCH",
            "state": "TX",
            "postal_code": "780154437",
            "telephone_number": "318-376-3819"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4502 Medical Dr",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "782294402",
            "country_code": "US",
            "telephone_number": "210-358-4000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THEISS",
        "first_name": "MARY",
        "middle_name": "AMANDA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-19",
        "last_updated": "2024-05-23",
        "certification_date": "2024-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TX",
            "license": "879598",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "1030889",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fair Oaks Ranch, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 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.