Individual provider Active NPI

John A Chaucer, CRNA

  • Certified Registered Nurse Anesthetist
  • Dallas, TX
National Provider Identifier
1366688285
Registry record updated Jun 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
709225 Issued in TX
Practice address
6606 Lyndon B Johnson Fwy Ste 200
Dallas, TX 75240-6524
Phone
(972) 715-5000
Fax
(972) 715-9976
NPI assigned
Dec 23, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2020

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 709225 TX Primary

Addresses

Primary practice location

6606 Lyndon B Johnson Fwy Ste 200
Dallas, TX 75240-6524

Mailing address

PO Box 840853
Dallas, TX 75284-0426
Phone (972) 715-5000

Other identifiers 5

IdentifierTypeStateIssuer
2224617OtherTXDRIVER LICENSE
199514402MedicaidTX
89694UOtherTXBCBS
709225OtherTXSTATE LICENSE
P00679407OtherTXRAILROAD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090206000246 TX Practitioner - Certified Registered Nurse Anesthetist (Crna) 7719042704 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Trident Anesthesia LLCGroup PAC ID 3274817879, 4 clinicians

Practice addresses (Care Compare)

3920 W Wheatland Rd
Suite 108
Dallas, TX 75237-3401
Phone (713) 575-3686

5425 W Spring Creek Pkwy
Suite 100
Plano, TX 75024-4268
Phone (469) 945-6814

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
709225TXMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Trident Anesthesia LLC Nurse Anesthetist, Certified Registered CurrentSince Oct 17, 2016 Accepting new patients
Alliance Anesthesia Associates, PA Nurse Anesthetist, Certified Registered Past Accepting new patients
Apex Anesthesia Consultants, PLLC Past Accepting new patients

Locations

400 10th St E
Waconia, MN 55387

800 W Arbrook Blvd
Ste 120
Arlington, TX 76015
Phone (817) 468-4343

17110 Dallas Pkwy
Ste 105
Dallas, TX 75248
Phone (972) 483-5714

3920 W Wheatland Rd
Ste 108
Dallas, TX 75237
Phone (214) 948-7779

17950 Preston Rd
Ste 120
Dallas, TX 75252
Phone (214) 915-8979

2001 Cooper St
Ft Worth, TX 76104
Phone (817) 334-0990

7201 Wyoming Springs Dr
Ste 100
Round Rock, TX 78681
Phone (817) 727-0985

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1229990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592870400000",
    "number": "1366688285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 840853",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752840426",
            "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 LYNDON B JOHNSON FWY STE 200",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752406524",
            "telephone_number": "972-715-5000",
            "fax_number": "972-715-9976"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAUCER",
        "first_name": "JOHN",
        "middle_name": "A",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-12-23",
        "last_updated": "2020-06-23",
        "certification_date": "2020-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "709225",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DRIVER LICENSE",
            "identifier": "2224617",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "199514402",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "89694U",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "709225",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD",
            "identifier": "P00679407",
            "state": "TX"
        }
    ],
    "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 Jun 23, 2020; 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.