Individual provider Active NPI

Peter Idolo, CRNA

  • Certified Registered Nurse Anesthetist
  • McKinney, TX
National Provider Identifier
1508288341
Registry record updated Sep 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
AP144813 Issued in TX
Practice address
4510 Medical Center Dr Ste 211
McKinney, TX 75069-1602
Phone
(469) 541-1600
Fax
(469) 541-1612
NPI assigned
Jan 14, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 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 COA.15533-NA OH
Certified Registered Nurse Anesthetist 367500000X AP144813 TX Primary

Addresses

Primary practice location

4510 Medical Center Dr Ste 211
McKinney, TX 75069-1602

Mailing address

906 W McDermott Dr # 116-371
Allen, TX 75013-6510
Phone (469) 541-1600

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200615000113 TX Practitioner - Certified Registered Nurse Anesthetist (Crna) 8628208238 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2013
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
Orthomed Staffing LLCGroup PAC ID 9638429178, 373 clinicians

Practice addresses (Care Compare)

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

7211 Preston Rd
Suite 2100
Plano, TX 75024-0258
Phone (469) 303-0104

Hospital & facility affiliations

  • Methodist Richardson Medical Center Hospital, Richardson, TX, CCN 450537
  • Texas Health Presbyterian Hospital Allen Hospital, Allen, TX, CCN 450840

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
COA.15533-NAOHMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Emergenchealth PLLC Nurse Anesthetist, Certified Registered CurrentSince Dec 1, 2021 Accepting new patients
Spine Team Texas, PA CurrentSince Nov 1, 2021 Accepting new patients
Spine Team Texas PA CurrentSince Nov 1, 2021 Accepting new patients
Orthomed Staffing LLC CurrentSince May 1, 2022 Accepting new patients
DFW Oba PLLC CurrentSince May 1, 2023 Accepting new patients
Allen Anesthesia Associates CurrentSince Sep 1, 2021 Accepting new patients

Locations

906 W McDermott Dr
Allen, TX 75013
Phone (918) 812-4755

1105 Central Expy N
Allen, TX 75013
Phone (972) 747-4313

1105 Central Expy N
Ste 210
Allen, TX 75013
Phone (972) 747-4646

801 W Interstate 20
Arlington, TX 76017
Phone (817) 472-3400

2727 E Lemmon Ave
Dallas, TX 75204
Phone (214) 443-3000

7 Medical Pkwy
Farmers Brnch, TX 75234
Phone (972) 247-1000

4401 Coit Rd
Ste 100
Frisco, TX 75035
Phone (214) 619-0120

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

4510 Medical Center Dr
Ste 211
McKinney, TX 75069
Phone (469) 541-1600

7211 Preston Rd
Ste 2100
Plano, TX 75024
Phone (469) 303-0104

2201 K Ave
Ste B100
Plano, TX 75074
Phone (214) 931-6133

990 S Sherman St
Richardson, TX 75081
Phone (972) 788-0350

3142 Horizon Rd
Ste 100
Rockwall, TX 75032
Phone (682) 651-1908

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

2118 E State Highway 114
Southlake, TX 76092
Phone (817) 488-0410

1545 E Southlake Blvd
Ste 100
Southlake, TX 76092

Organizations & group practices 7

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 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": "1389657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695859200000",
    "number": "1508288341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "906 W MCDERMOTT DR # 116-371",
            "city": "ALLEN",
            "state": "TX",
            "postal_code": "750136510",
            "telephone_number": "469-541-1600",
            "fax_number": "469-541-1612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4510 MEDICAL CENTER DR STE 211",
            "city": "MCKINNEY",
            "state": "TX",
            "postal_code": "750691602",
            "telephone_number": "469-541-1600",
            "fax_number": "469-541-1612"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IDOLO",
        "first_name": "PETER",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-01-14",
        "last_updated": "2023-09-28",
        "certification_date": "2023-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "OH",
            "license": "COA.15533-NA",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "AP144813",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in McKinney, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 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.