Individual provider Active NPI

Luis Jaime Marichalar, CRNA

  • Certified Registered Nurse Anesthetist
  • Edinburg, TX
National Provider Identifier
1316375231
Registry record updated Jan 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
AP124489 Issued in TX
Practice address
5501 S McColl Rd
Edinburg, TX 78539-9152
Phone
(956) 661-0529
Fax
(956) 618-4639
NPI assigned
Oct 31, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2022

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 AP124489 TX Primary

Addresses

Primary practice location

5501 S McColl Rd
Edinburg, TX 78539-9152

Mailing address

7432 N 5TH St
McAllen, TX 78504-1845
Phone (602) 330-1653

Other practice location 1

610 Kaimali Dr
Harlingen, TX 78550-0233
Phone (956) 371-2243

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140206001306 TX Practitioner - Certified Registered Nurse Anesthetist (Crna) 2466681705 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Renaissance Specialist ClinicGroup PAC ID 4284111691, 38 clinicians

Practice addresses (Care Compare)

5501 S McColl Rd
Edinburg, TX 78539-5503
Phone (956) 362-2171

Hospital & facility affiliations

  • Doctors Hosptal at Renaissance Hospital, Edinburg, TX, CCN 450869

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP124489TXMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Sportsortho Anesthesia CurrentSince May 7, 2022 Accepting new patients
Renaissance Specialist Clinic CurrentSince Feb 1, 2026 Accepting new patients
Renaissance Medical Foundation Current Accepting new patients

Locations

5501 S McColl Rd
Edinburg, TX 78539
Phone (956) 362-3300

610 Kamali Dr
Harlingen, TX 78550
Phone (956) 232-3088

Organizations & group practices 4

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 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": "1383177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643068800000",
    "number": "1316375231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7432 N 5TH ST",
            "city": "MCALLEN",
            "state": "TX",
            "postal_code": "785041845",
            "telephone_number": "602-330-1653"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5501 S MCCOLL RD",
            "city": "EDINBURG",
            "state": "TX",
            "postal_code": "785399152",
            "telephone_number": "956-661-0529",
            "fax_number": "956-618-4639"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "610 Kaimali Dr",
            "address_purpose": "LOCATION",
            "city": "Harlingen",
            "state": "TX",
            "postal_code": "785500233",
            "country_code": "US",
            "telephone_number": "956-371-2243",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARICHALAR",
        "first_name": "LUIS",
        "middle_name": "JAIME",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-10-31",
        "last_updated": "2022-01-25",
        "certification_date": "2022-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "AP124489",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edinburg, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2022; 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.