Individual provider Active NPI

Javier Ruiz, CRNA

  • Certified Registered Nurse Anesthetist
  • Houston, TX
National Provider Identifier
1245549351
Registry record updated Feb 16, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
791200 Issued in TX
Practice address
1515 Holcombe Blvd
Houston, TX 77030-4009
Phone
(713) 792-6161
NPI assigned
Oct 7, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2011

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 791200 TX Primary

Addresses

Primary practice location

1515 Holcombe Blvd
Houston, TX 77030-4009

Mailing address

PO Box 4439
Houston, TX 77210-4439
Phone (713) 792-2991

Other identifiers 2

IdentifierTypeStateIssuer
836N01OtherTXBCBS
217074801MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, WA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20101210001003 TX Practitioner - Certified Registered Nurse Anesthetist (Crna) 0749477156 Reassigns benefits to 1 organization
I20230407001726 WA Practitioner - Certified Registered Nurse Anesthetist (Crna) 0749477156 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
791200TXMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Olympic Anesthesia Services, Inc CurrentSince May 1, 2023 Accepting new patients

Locations

2520 Cherry Ave
Bremerton, WA 98310
Phone (360) 377-3911

990 Sylvan Way
Bremerton, WA 98310
Phone (360) 479-3654

20669 Bond Rd NE
Ste 200
Poulsbo, WA 98370
Phone (360) 779-6527

1800 NW Myhre Rd
Silverdale, WA 98383
Phone (360) 337-8800

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1286409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1297814400000",
    "number": "1245549351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4439",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "772104439",
            "telephone_number": "713-792-2991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 HOLCOMBE BLVD",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770304009",
            "telephone_number": "713-792-6161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUIZ",
        "first_name": "JAVIER",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-10-07",
        "last_updated": "2011-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "791200",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "836N01",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "217074801",
            "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 Feb 16, 2011; 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.