Individual provider Active NPI

Melanie Licerio, CRNA

  • Certified Registered Nurse Anesthetist
  • Dallas, TX
National Provider Identifier
1346633211
Registry record updated Mar 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
AP127432 Issued in TX
Practice address
6606 LBJ Fwy
Suite 200
Dallas, TX 75240-6533
Phone
(972) 715-5000
Fax
(972) 715-9976
NPI assigned
Mar 16, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 20, 2017

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 AP127432 TX Primary

Addresses

Primary practice location

6606 LBJ Fwy
Suite 200
Dallas, TX 75240-6533

Mailing address

PO Box 650865
Dallas, TX 75265-0865
Phone (972) 715-5000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150826001569 TX Practitioner - Certified Registered Nurse Anesthetist (Crna) 8628384369 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Guide Anesthesia TX PLLCGroup PAC ID 5294170379, 35 clinicians
BHS Physicians Network, IncGroup PAC ID 7315019593, 702 clinicians

Practice addresses (Care Compare)

125 W Castellano Dr
El Paso, TX 79912-6108
Phone (915) 532-8200

3280 Joe Battle Blvd
El Paso, TX 79938-2622
Phone (915) 832-2000

3903 Wiseman Blvd
San Antonio, TX 78251-4402
Phone (210) 946-1400

PO Box
Suite 5730
Belfast, ME 04915-5700

Hospital & facility affiliations

  • The Hospitals of Providence - East Campus Hospital, El Paso, TX, CCN 670047
  • University Medical Center of El Paso Hospital, El Paso, TX, CCN 450024

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP127432TXMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
BHS Physicians Network, Inc CurrentSince Nov 30, 2017 Accepting new patients
U. S. Anesthesia Partners of Texas, P.a., Nurse Anesthetist, Certified Registered CurrentSince Jun 17, 2016 Accepting new patients
U S Anesthesia Partners of Texas, PA Nurse Anesthetist, Certified Registered CurrentSince Jun 17, 2016 Accepting new patients
BHS Physicians Network, Inc CurrentSince Nov 30, 2017 Accepting new patients
Guide Anesthesia TX PLLC Nurse Anesthetist, Certified Registered CurrentSince May 15, 2024 Accepting new patients
BHS Specialty Network Inc Past Accepting new patients

Locations

4600 E Washington St
Ste 300
Phoenix, AZ 85034
Phone (602) 638-1872

4401 Garth Rd
Baytown, TX 77521
Phone (281) 420-8500

10301 Gateway Blvd W
El Paso, TX 79925
Phone (915) 543-2424

1625 Medical Center Dr
El Paso, TX 79902
Phone (915) 577-7746

1300 Murchison Dr
Ste 200
El Paso, TX 79902
Phone (915) 225-7600

125 W Castellano Dr
El Paso, TX 79912
Phone (915) 532-8200

1125 Texas Ave
Ste 502
El Paso, TX 79901
Phone (915) 915-5030

1801 N Oregon St
El Paso, TX 79902
Phone (409) 883-9361

2411 Fountain View Dr
Ste 200
Houston, TX 77057
Phone (713) 458-4185

7600 Beechnut St
Houston, TX 77074
Phone (713) 456-5000

100 Medical Dr
Lake Jackson, TX 77566
Phone (713) 496-7555

3903 Wiseman Blvd
Ste 100
San Antonio, TX 78251
Phone (210) 681-0126

3903 Wiseman Blvd
San Antonio, TX 78251
Phone (210) 681-0126

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 4

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": "1426464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489968000000",
    "number": "1346633211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 650865",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752650865",
            "telephone_number": "972-715-5000",
            "fax_number": "972-715-9976"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6606 LBJ FWY",
            "address_2": "SUITE 200",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752406533",
            "telephone_number": "972-715-5000",
            "fax_number": "972-715-9976"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LICERIO",
        "first_name": "MELANIE",
        "name_prefix": "Mrs.",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-03-16",
        "last_updated": "2017-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "AP127432",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2017; 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.