Active NPI
Philip Paul Adamczak
- Certified Registered Nurse Anesthetist
- Houston, TX
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 043809
- Practice address
- 2411 Fountain View Dr
Suite 200
Houston, TX 77057-4817 - Phone
- (713) 458-4185
- NPI assigned
- Jan 8, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | 043809 | TX | Primary |
Addresses
Primary practice location
2411 Fountain View Dr
Suite 200
Houston, TX 77057-4817
Mailing address
2411 Fountain View Dr Ste 200
Houston, TX 77057-4832
Phone (713) 620-4000
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 430029332 | Other | TX | RAILROAD MEDICARE |
| 003351601 | Medicaid | TX | |
| 88588C | Other | TX-BLUE SHIELD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 043809 | TX | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Utmb Faculty Group Practice | Current | Accepting new patients | |
| Sound Physicians Anesthesiology of Texas PLLC | Current | Accepting new patients | |
| Northstar Anesthesia, PA | Nurse Anesthetist, Certified Registered | Current | Accepting new patients |
Locations
2000 E Lamar Blvd
Ste 400
Arlington, TX 76006
Phone (817) 861-3994
909 9th Ave
Ft Worth, TX 76104
Phone (817) 336-6060
2001 W Rosedale St
Ft Worth, TX 76104
Phone (817) 877-4777
301 University Blvd
Galveston, TX 77555
Phone (409) 747-1883
1401 St Joseph Pkwy
Houston, TX 77002
Phone (713) 575-1000
1917 Ashland St
Houston, TX 77008
Phone (713) 861-6161
6560 Fannin St
Ste 600
Houston, TX 77030
Phone (713) 796-0500
6200 W Parker Rd
Plano, TX 75093
Phone (972) 608-8000
Organizations & group practices 3
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.
-
- Anesthesiology Physician
- Arlington, TX
- NPI 1912978610
Nurse Anesthetist, Certified Registered
-
- Anesthesiology Physician
- Fort Worth, TX
- NPI 1295356277
-
- General Practice Physician
- Galveston, TX
- NPI 1942241146
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168214400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1218153600000",
"number": "1255489704",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2411 FOUNTAIN VIEW DR STE 200",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770574832",
"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": "SUITE 200",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770574817",
"telephone_number": "713-458-4185"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ADAMCZAK",
"first_name": "PHILIP",
"middle_name": "PAUL",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-08",
"last_updated": "2008-08-08",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "TX",
"license": "043809",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "430029332",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "003351601",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TX-BLUE SHIELD",
"identifier": "88588C",
"state": null
}
],
"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 Aug 8, 2008; 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.