Individual provider Active NPI

Michael Blaine Nesmith, CRNA

  • Certified Registered Nurse Anesthetist
  • Dallas, TX
National Provider Identifier
1417934431
Registry record updated Oct 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
619214 Issued in TX
Practice address
6606 LBJ Fwy
Suite 200
Dallas, TX 75240-6533
Phone
(972) 715-5000
Fax
(972) 715-9976
NPI assigned
Dec 30, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 619214 IN
Certified Registered Nurse Anesthetist 367500000X 619214 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

Other practice location 1

600 Mary St
Evansville, IN 47710-1658
Phone (812) 450-2240

Other practice location 2

4011 Gateway Blvd
Newburgh, IN 47630-8947
Phone (812) 450-2240

Other identifiers 3

IdentifierTypeStateIssuer
P01446623OtherTXRR
8973UGOtherTXBCBS
165515106MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, MN, IN3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20040607001619 TX Practitioner - Certified Registered Nurse Anesthetist (Crna) 3476536996 Reassigns benefits to 2 organizations
I20230714002570 MN Practitioner - Certified Registered Nurse Anesthetist (Crna) 3476536996 Reassigns benefits to 1 organization
I20240206001136 IN Practitioner - Certified Registered Nurse Anesthetist (Crna) 3476536996 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Texas Allied Anesthesia, PLLCGroup PAC ID 1052698172, 23 clinicians
Deaconess Hospital, Inc.Group PAC ID 9032021431, 410 clinicians

Practice addresses (Care Compare)

Richardson, TX 75080
Phone (214) 660-5266

1300 Anne St NW
Bemidji, MN 56601-5103
Phone (218) 333-5000

1611 Anne St NW
Bemidji, MN 56601-5114
Phone (218) 333-5000

600 Mary St
Evansville, IN 47710-1658
Phone (812) 450-7299

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
86.56 of 100Reported as group
Quality
74.25
Promoting interoperability
100
Improvement activities
40
Cost
76.16

Merit-based Incentive Payment System (MIPS)

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

Merit-based Incentive Payment System (MIPS)

Final score
87.17 of 100Reported as group
Quality
82.57
Promoting interoperability
100
Improvement activities
40
Cost
71.91

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2849MNMDMarriage & Family Therapist
619214INMDCertified Registered Nurse Anesthetist
619214TXMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Deaconess Hospital, Inc Nurse Anesthetist, Certified Registered CurrentSince Jan 2, 2024 Accepting new patients
Texas Allied Anesthesia, PLLC Nurse Anesthetist, Certified Registered CurrentSince Apr 28, 2024 Accepting new patients
Anesthesia Partners of Dallas PLLC CurrentSince Feb 15, 2022 Accepting new patients
Sanford Health of Northern Minnesota CurrentSince Jun 3, 2023 Accepting new patients
Deaconess Hospital, Inc Current Accepting new patients
Deaconess Hospital Inc CurrentSince Jan 2, 2024 Accepting new patients
Sanford Health of Northern Minnesota Current Accepting new patients
Sanford Health of Northern Minnesota CurrentSince Jun 3, 2023 Accepting new patients
Sundance Anesthesia PA Past Accepting new patients
Apex Anesthesia Consultants, PLLC Past Accepting new patients

Locations

600 Mary St
Evansville, IN 47710
Phone (812) 450-2239

4011 Gateway Blvd
Newburgh, IN 47630
Phone (812) 450-2240

1611 Anne St NW
Bemidji, MN 56601
Phone (218) 333-2020

1400 Highway 71
Intl Falls, MN 56649
Phone (218) 283-4481

14850 Quorum Dr
Ste 400
Dallas, TX 75254
Phone (214) 801-1879

8200 Walnut Hill Ln
Dallas, TX 75231
Phone (214) 345-6148

701 Tuscan Dr
Ste 100
Irving, TX 75039
Phone (214) 496-1100

2221 Lakeside Blvd
Ste 600
Richardson, TX 75082
Phone (469) 998-7450

2435 N Central Expy
Ste 1200
Richardson, TX 75080
Phone (214) 442-1900

Organizations & group practices 10

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": "1135900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697760000000",
    "number": "1417934431",
    "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"
        },
        {
            "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": [
        {
            "address_1": "600 Mary St",
            "address_purpose": "LOCATION",
            "city": "Evansville",
            "state": "IN",
            "postal_code": "477101658",
            "country_code": "US",
            "telephone_number": "812-450-2240",
            "fax_number": "812-450-2710",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4011 Gateway Blvd",
            "address_purpose": "LOCATION",
            "city": "Newburgh",
            "state": "IN",
            "postal_code": "476308947",
            "country_code": "US",
            "telephone_number": "812-450-2240",
            "fax_number": "812-450-2710",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NESMITH",
        "first_name": "MICHAEL",
        "middle_name": "BLAINE",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-30",
        "last_updated": "2023-10-20",
        "certification_date": "2023-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IN",
            "license": "619214",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "619214",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR",
            "identifier": "P01446623",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8973UG",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "165515106",
            "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 Oct 20, 2023; 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.