Individual provider Active NPI

Julie Marie Boytim, RN, CRNA

  • Certified Registered Nurse Anesthetist
  • Houston, TX
National Provider Identifier
1386830966
Registry record updated Jul 7, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
686777 Issued in TX
Practice address
2411 Fountain View Dr
Ste 200
Houston, TX 77057-4817
Phone
(713) 620-4000
NPI assigned
Sep 18, 2007
Last updated
Jul 7, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2015

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 686777 TX Primary

Addresses

Primary practice location

2411 Fountain View Dr
Ste 200
Houston, TX 77057-4817

Mailing address

1737 Briarcrest Dr 14
Bryan, TX 77802-2739
Phone (979) 776-4777

Other identifiers 3

IdentifierTypeStateIssuer
2104039MedicaidLA
P00821827OtherTXRAILROAD MEDICARE
191904502MedicaidTX

Other names 1

  • Julie Marie Light Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080227000345 TX Practitioner - Certified Registered Nurse Anesthetist (Crna) 9133203367 Reassigns benefits to 6 organizations

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
Emergenchealth PLLCGroup PAC ID 1355606641, 1,037 clinicians

Practice addresses (Care Compare)

3811 Sagebriar Dr
Bryan, TX 77802-6107
Phone (979) 774-9053

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
686777TXMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Scott & White Clinic Current Accepting new patients
Cowboy Anesthesia Services PLLC CurrentSince Jun 1, 2024 Accepting new patients
Emergenchealth PLLC Nurse Anesthetist, Certified Registered CurrentSince Dec 1, 2021 Accepting new patients
Anesthesia Associates of Bryan LLC Nurse Anesthetist, Certified Registered CurrentSince Apr 6, 2015 Accepting new patients
Austin Anesthesiology Group, PLLC Nurse Anesthetist, Certified Registered Current Accepting new patients
Scott & White Clinic CurrentSince May 11, 2016 Accepting new patients
Scott & White Clinic CurrentSince May 11, 2016 Accepting new patients
Youngs Professional Services LLC Nurse Anesthetist, Certified Registered CurrentSince Jan 1, 2019 Accepting new patients

Locations

919 E 32nd St
Austin, TX 78705
Phone (512) 343-2466

44 N Cummings St
Bellville, TX 77418
Phone (979) 413-7400

2206 E Villa Maria Rd
Bryan, TX 77802
Phone (979) 774-4211

2801 Franciscan Dr
Bryan, TX 77802
Phone (409) 776-3777

3811 Sagebriar Dr
Bryan, TX 77802
Phone (979) 774-0498

1280 Arrington Rd
Ste 200
College Station, TX 77845
Phone (979) 207-6550

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

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

7400 Barlite Blvd
San Antonio, TX 78224
Phone (210) 921-2000

1305 Wonder World Dr
Ste 105
San Marcos, TX 78666
Phone (512) 353-8161

10141 US 59 Hwy
Wharton, TX 77488
Phone (281) 491-6808

Organizations & group practices 8

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.

Hospital & facility affiliations 1

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": "1190073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1436227200000",
    "number": "1386830966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1737 BRIARCREST DR 14",
            "city": "BRYAN",
            "state": "TX",
            "postal_code": "778022739",
            "telephone_number": "979-776-4777",
            "fax_number": "979-776-0588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2411 FOUNTAIN VIEW DR",
            "address_2": "STE 200",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770574817",
            "telephone_number": "713-620-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOYTIM",
        "first_name": "JULIE",
        "middle_name": "MARIE",
        "credential": "RN, CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-18",
        "last_updated": "2015-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "686777",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2104039",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00821827",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "191904502",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JULIE",
            "last_name": "LIGHT",
            "middle_name": "MARIE",
            "credential": "RN, CRNA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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 Jul 7, 2015; 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.