Individual provider Active NPI

Andrew Ardoin, CRNA

  • Certified Registered Nurse Anesthetist
  • Sugar Land, TX
National Provider Identifier
1609966688
Registry record updated Apr 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
650241 Issued in TX
Practice address
1211 Highway 6
South Suite 70
Sugar Land, TX 77478-4941
Phone
(228) 547-7747
NPI assigned
Oct 13, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 9, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 650241 TX Primary

Addresses

Primary practice location

1211 Highway 6
South Suite 70
Sugar Land, TX 77478-4941

Mailing address

3703 Drummond St
Houston, TX 77025-2417
Phone (713) 553-3983

Other identifiers 2

IdentifierTypeStateIssuer
000019377AOtherMSBCBS
4032778MedicaidMS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110110000177 TX Practitioner - Certified Registered Nurse Anesthetist (Crna) 8022050210 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Independent Physicians Network PLLCGroup PAC ID 5496029407, 218 clinicians

Practice addresses (Care Compare)

3625 N Hall St
Suite 800
Dallas, TX 75219-5106
Phone (214) 252-3535

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
650241TXMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Independent Physicians Network PLLC CurrentSince Nov 1, 2022 Accepting new patients
Pediatric Dentistry of Keller PLLC PastSince Jul 28, 2019 Accepting new patients

Locations

3625 N Hall St
Ste 800
Dallas, TX 75219
Phone (214) 252-3500

3300 Oak Lawn Ave
Ste 200
Dallas, TX 75219
Phone (214) 252-3500

5858 Westheimer Rd
Ste 82
Houston, TX 77057
Phone (713) 784-6065

1627 Keller Pkwy
Ste 100
Keller, TX 76248
Phone (480) 207-9709

6200 W Parker Rd
Plano, TX 75093
Phone (972) 608-8000

17510 W Grand Pkwy S
Ste 200
Sugar Land, TX 77479
Phone (281) 238-1600

Organizations & group practices 2

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": "1160697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1333929600000",
    "number": "1609966688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3703 DRUMMOND ST",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770252417",
            "telephone_number": "713-553-3983"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1211 HIGHWAY 6",
            "address_2": "SOUTH SUITE 70",
            "city": "SUGAR LAND",
            "state": "TX",
            "postal_code": "774784941",
            "telephone_number": "228-547-7747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARDOIN",
        "first_name": "ANDREW",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-13",
        "last_updated": "2012-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "650241",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "000019377A",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4032778",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sugar Land, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2012; 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.