Individual provider Active NPI

Ilya Malaniy, CRNA

  • Certified Registered Nurse Anesthetist
  • Dallas, TX
National Provider Identifier
1407124423
Registry record updated Jun 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
AP121353 Issued in TX
Practice address
6606 LBJ Fwy Ste 200
Dallas, TX 75240-6524
Phone
(972) 715-5000
Fax
(972) 715-9976
NPI assigned
Dec 5, 2011
Last updated
Jun 30, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 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 AP121353 TX Primary

Addresses

Primary practice location

6606 LBJ Fwy Ste 200
Dallas, TX 75240-6524

Mailing address

PO Box 840853
Dallas, TX 75284-0865
Phone (972) 715-5000

Other identifiers 2

IdentifierTypeStateIssuer
302607204MedicaidTX
8552UJOtherTXBCBS TX

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120418000619 TX Practitioner - Certified Registered Nurse Anesthetist (Crna) 0749441715 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
U S Anesthesia Partners of Texas, PAGroup PAC ID 7315850351, 2,750 clinicians
Endo Sedation LLCGroup PAC ID 4789845363, 289 clinicians

Practice addresses (Care Compare)

2831 E President George Bush Hwy
Greater Houston Anesthesiology
Richardson, TX 75082-3561
Phone (469) 204-0702

3107 W Camp Wisdom Rd
Suite 189
Dallas, TX 75237-2638
Phone (214) 331-2922

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.94 of 100Reported as group
Quality
91.31
Improvement activities
40
Cost
79.05

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP121353TXMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
U S Anesthesia Partners of Texas, PA Nurse Anesthetist, Certified Registered CurrentSince Dec 29, 2014 Accepting new patients
U. S. Anesthesia Partners of Texas, P.a., Nurse Anesthetist, Certified Registered CurrentSince Dec 29, 2014 Accepting new patients
Endo Sedation LLC Nurse Anesthetist, Certified Registered CurrentSince Nov 12, 2021 Accepting new patients
Endo Sedation LLC Nurse Anesthetist, Certified Registered CurrentSince Nov 12, 2021 Accepting new patients
Anesthesia Consultants of Dallas LLP Past Accepting new patients
Dallas Anesthesia & Pain Medicine Specialists LLP Past Accepting new patients
Excel Anesthesia, PA Past Accepting new patients
Veritas Anesthesia, LLP Past Accepting new patients

Locations

12222 Merit Dr
Ste 600
Dallas, TX 75251
Phone (972) 776-3185

1441 N Beckley Ave
Dallas, TX 75203
Phone (214) 712-2429

3107 W Camp Wisdom Rd
Ste 189
Dallas, TX 75237
Phone (214) 331-2922

3500 W Wheatland Rd
Dallas, TX 75237
Phone (214) 947-5950

3500 W Wheatland Rd
#M
Dallas, TX 75237
Phone (214) 947-7699

7777 Forest Ln
Dallas, TX 75230
Phone (972) 566-7283

9500 N Central Expy
Ste 200
Dallas, TX 75231
Phone (214) 739-9544

1001 Surrey Ln
Flower Mound, TX 75022
Phone (817) 337-3671

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

180 Bear Creek Pkwy
Keller, TX 76248
Phone (817) 337-3671

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

2704 N Galloway Ave
Ste 102
Mesquite, TX 75150
Phone (972) 961-7171

3500 Preston Rd
Ste 200
Plano, TX 75093
Phone (972) 985-2300

2831 George Bush Hwy
Richardson, TX 75082
Phone (469) 204-1000

9250 Pinecroft Dr
Shenandoah, TX 77380
Phone (281) 364-2300

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 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": "1323043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593475200000",
    "number": "1407124423",
    "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": "752840865",
            "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 STE 200",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752406524",
            "telephone_number": "972-715-5000",
            "fax_number": "972-715-9976"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALANIY",
        "first_name": "ILYA",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-12-05",
        "last_updated": "2020-06-30",
        "certification_date": "2020-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "AP121353",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "302607204",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS TX",
            "identifier": "8552UJ",
            "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 30, 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.