NPIMap

Organization Active NPI

Northstar Anesthesia II PA

  • Anesthesiology Physician
  • Burleson, TX
National Provider Identifier
1477066405
Registry record updated May 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
NORTHSTAR ANESTHESIA II PA
Practice address
11801 South Fwy
Burleson, TX 76028-7021
Phone
(817) 293-9110
NPI assigned
Nov 13, 2017
Last updated
May 25, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 25, 2021

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

Authorized official

Name
Dr. Philip W Eichenholz, MD
Title
President
Phone
(214) 687-0008

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X
Anesthesiology Physician 207L00000X Primary

Addresses

Primary practice location

11801 South Fwy
Burleson, TX 76028-7021

Mailing address

PO Box 224563
Dallas, TX 75222-4563
Phone (239) 610-0775

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180110000102 TX Part B Supplier - Clinic/Group Practice 2365701737 Receives reassigned benefits from 429 practitioners
Practice locations: Brownsville, TX; Burleson, TX; Corpus Christi, TX; Fort Worth, TX; Georgetown, TX; Greenville, TX

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 440

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 440

NPI Registry JSON

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

{
    "created_epoch": "1510531200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1621900800000",
    "number": "1477066405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 224563",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752224563",
            "telephone_number": "239-610-0775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11801 SOUTH FWY",
            "city": "BURLESON",
            "state": "TX",
            "postal_code": "760287021",
            "telephone_number": "817-293-9110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHSTAR ANESTHESIA II PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-13",
        "last_updated": "2021-05-25",
        "certification_date": "2021-05-25",
        "status": "A",
        "authorized_official_last_name": "EICHENHOLZ",
        "authorized_official_first_name": "PHILIP",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "214-687-0008",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burleson, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.