Individual provider Active NPI

Theresa Ann Soto, CRNA

  • Certified Registered Nurse Anesthetist
  • Marble Falls, TX
National Provider Identifier
1568630002
Registry record updated Oct 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
AP120565 Issued in TX
Practice address
810 W Highway 71
Marble Falls, TX 78654-8602
Phone
(830) 201-8000
Fax
(830) 201-8008
NPI assigned
Feb 19, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2020

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 801061 TX
Certified Registered Nurse Anesthetist 367500000X AP120565 TX Primary

Addresses

Primary practice location

810 W Highway 71
Marble Falls, TX 78654-8602

Mailing address

PO Box 844658
Dallas, TX 75284-4658
Phone (727) 823-2188

Other identifiers 3

IdentifierTypeStateIssuer
G4512OtherFLBCBS
308983500MedicaidFL
P00712337OtherRAILROAD MEDICARE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address tsoto69915@direct.sw.org Direct

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111220000339 TX Practitioner - Certified Registered Nurse Anesthetist (Crna) 0143309278 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mark Malone MD PAGroup PAC ID 2567369424, 102 clinicians

Practice addresses (Care Compare)

6000 S Mopac
Suite 100
Austin, TX 78749
Phone (512) 244-4272

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mark Malone MD PA Current Accepting new patients
Mark Malone MD PA CurrentSince Dec 17, 2021 Accepting new patients
Mark Malone, MD PA CurrentSince Dec 17, 2021 Accepting new patients
Bayfront Anesthestia Services PA Past Accepting new patients

Locations

6000 S Mopac Expy
Ste 100
Austin, TX 78749

1106 College St
Ste C
Bastrop, TX 78602
Phone (512) 244-2895

2000 S Mays St
Ste 201
Round Rock, TX 78664
Phone (512) 492-3743

Networks

  • Optimum HealthCare HMO Network

Interoperability endpoints

  • Direct secure messaging: tsoto69915@direct.sw.org

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1203379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604016000000",
    "number": "1568630002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 844658",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752844658",
            "telephone_number": "727-823-2188",
            "fax_number": "727-828-0723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "810 W HIGHWAY 71",
            "city": "MARBLE FALLS",
            "state": "TX",
            "postal_code": "786548602",
            "telephone_number": "830-201-8000",
            "fax_number": "830-201-8008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOTO",
        "first_name": "THERESA",
        "middle_name": "ANN",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-02-19",
        "last_updated": "2020-10-30",
        "certification_date": "2020-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "801061",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "AP120565",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "G4512",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "308983500",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00712337",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tsoto69915@direct.sw.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "810 W Highway 71",
            "city": "Marble Falls",
            "state": "TX",
            "country_code": "US",
            "postal_code": "786548602",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Marble Falls, TX

Sources for this page

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