NPIMap

Organization Active NPI

PSB Anesthesia PA

  • Certified Registered Nurse Anesthetist
  • Addison, TX
National Provider Identifier
1508615444
Registry record updated May 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
Legal business name
PSB ANESTHESIA PA
Practice address
17051 Dallas Pkwy Ste 300
Addison, TX 75001-7105
Phone
(214) 888-3900
NPI assigned
May 14, 2024
Last updated
May 14, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 14, 2024

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

Authorized official

Name
Nathan Walters, MDNPI 1639259294
Title
Partner/Physician
Phone
(214) 888-3900

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

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

Addresses

Primary practice location

17051 Dallas Pkwy Ste 300
Addison, TX 75001-7105

Mailing address

PO Box 1889
Muncie, IN 47308-1889
Phone (765) 284-0493

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240808001384 TX Part B Supplier - Clinic/Group Practice 2567909559 Receives reassigned benefits from 11 practitioners
Practice locations: Addison, TX; Carrollton, TX

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 13

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 13

NPI Registry JSON

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

{
    "created_epoch": "1715644800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715644800000",
    "number": "1508615444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1889",
            "city": "MUNCIE",
            "state": "IN",
            "postal_code": "473081889",
            "telephone_number": "765-284-0493"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17051 DALLAS PKWY STE 300",
            "city": "ADDISON",
            "state": "TX",
            "postal_code": "750017105",
            "telephone_number": "214-888-3900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PSB ANESTHESIA PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-14",
        "last_updated": "2024-05-14",
        "certification_date": "2024-05-14",
        "status": "A",
        "authorized_official_last_name": "WALTERS",
        "authorized_official_first_name": "NATHAN",
        "authorized_official_title_or_position": "PARTNER/PHYSICIAN",
        "authorized_official_telephone_number": "214-888-3900",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Addison, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2024; 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.