Individual provider Active NPI

Medley Perella, CRNA

  • Certified Registered Nurse Anesthetist
  • Fort Worth, TX
National Provider Identifier
1568930691
Registry record updated Aug 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
830126 Issued in TX
Practice address
801 7TH Ave
Fort Worth, TX 76104-2733
Phone
(682) 885-4054
Fax
(682) 885-7497
NPI assigned
Nov 7, 2018
Last updated
Aug 4, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2022

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 AP140447 TX
Certified Registered Nurse Anesthetist 367500000X 830126 TX Primary

Addresses

Primary practice location

801 7TH Ave
Fort Worth, TX 76104-2733

Mailing address

PO Box 733784
Dallas, TX 75373-3784
Phone (682) 885-1860

Other names 1

  • Medley Wollenman Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190326001296 TX Practitioner - Certified Registered Nurse Anesthetist (Crna) 7315287588 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2018
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
Endo Sedation LLCGroup PAC ID 4789845363, 289 clinicians

Practice addresses (Care Compare)

1441 N Beckley Ave
Greater Houston Anesthesiology
Dallas, TX 75203-1201
Phone (214) 947-2935

9500 N Central Expy
Suite 200
Dallas, TX 75231-5128
Phone (214) 739-9544

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

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

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
830126TXMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
U S Anesthesia Partners of Texas, PA Nurse Anesthetist, Certified Registered CurrentSince Feb 6, 2019 Accepting new patients
Cook Children's Physician Network CurrentSince May 11, 2020 Accepting new patients
U. S. Anesthesia Partners of Texas, P.a., Nurse Anesthetist, Certified Registered CurrentSince Feb 6, 2019 Accepting new patients
Endo Sedation LLC Nurse Anesthetist, Certified Registered CurrentSince May 24, 2022 Accepting new patients
Endo Sedation LLC Nurse Anesthetist, Certified Registered CurrentSince May 24, 2022 Accepting new patients
Cook Children's Physician Network CurrentSince May 11, 2020 Accepting new patients
Choice Anesthesia CurrentSince Oct 23, 2024 Accepting new patients

Locations

12222 Merit Dr
Ste 600
Dallas, TX 75251
Phone (972) 776-3185

1441 N Beckley Ave
Dallas, TX 75203
Phone (214) 712-2429

3107 W Camp Wisdom Rd
Ste 189
Dallas, TX 75237
Phone (214) 331-2922

3500 W Wheatland Rd
Dallas, TX 75237
Phone (214) 947-5950

9500 N Central Expy
Ste 200
Dallas, TX 75231
Phone (214) 739-9544

1001 Surrey Ln
Flower Mound, TX 75022
Phone (817) 337-3671

801 7th Ave
Ft Worth, TX 76104
Phone (682) 885-4054

180 Bear Creek Pkwy
Keller, TX 76248
Phone (817) 337-3671

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

2704 N Galloway Ave
Ste 102
Mesquite, TX 75150
Phone (972) 961-7171

136 El Chico Trl
Ste 102
Willow Park, TX 76087
Phone (817) 441-5412

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1541548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659571200000",
    "number": "1568930691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 733784",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753733784",
            "telephone_number": "682-885-1860",
            "fax_number": "682-885-1396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 7TH AVE",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761042733",
            "telephone_number": "682-885-4054",
            "fax_number": "682-885-7497"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERELLA",
        "first_name": "MEDLEY",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-07",
        "last_updated": "2022-08-04",
        "certification_date": "2022-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "AP140447",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "830126",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MEDLEY",
            "last_name": "WOLLENMAN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fort Worth, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2022; 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.