Individual provider Active NPI

Casey Mraz, MD

  • Family Medicine Physician
  • Midland, TX
National Provider Identifier
1659728855
Registry record updated Aug 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
S0748 Issued in TX
Practice address
3415 N Loop 250 W BLDG 4
Midland, TX 79707-6034
Phone
(432) 221-3300
NPI assigned
May 17, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X S0748 TX Primary

Addresses

Primary practice location

3415 N Loop 250 W BLDG 4
Midland, TX 79707-6034

Mailing address

4214 Andrews Hwy Ste 240
Midland, TX 79703-4817
Phone (432) 686-6605

Other identifiers 1

IdentifierTypeStateIssuer
786679OtherTXTX MCARE - PREMIER

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address casey.mraz.1@3522.direct.athenahealth.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190429002821 TX Practitioner - Family Practice 5890082325 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
S0748TXMDFamily Medicine Physician
50748TXMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Privia Medical Group West Texas, PLLC CurrentSince Jul 1, 2024 Accepting new patients
Privia Medical Group West Texas, PLLC CurrentSince Jul 1, 2024 Accepting new patients
Privia Medical Group West Texas, PLLC Past Accepting new patients

Locations

1665 Antilley Rd
Ste 170
Abilene, TX 79606
Phone (325) 437-8655

1600 Tarleton St
Midland, TX 79703
Phone (432) 704-5455

500 W 4th St
Odessa, TX 79761
Phone (432) 640-1000

Interoperability endpoints

  • Direct secure messaging: casey.mraz.1@23308.direct.athenahealth.com
  • Direct secure messaging: casey.mraz.1@3522.direct.athenahealth.com

Organizations & group practices 3

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": "1463443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597363200000",
    "number": "1659728855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4214 ANDREWS HWY STE 240",
            "city": "MIDLAND",
            "state": "TX",
            "postal_code": "797034817",
            "telephone_number": "432-686-6605",
            "fax_number": "432-682-2284"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3415 N LOOP 250 W BLDG 4",
            "city": "MIDLAND",
            "state": "TX",
            "postal_code": "797076034",
            "telephone_number": "432-221-3300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MRAZ",
        "first_name": "CASEY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-17",
        "last_updated": "2020-08-14",
        "certification_date": "2020-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "S0748",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TX MCARE - PREMIER",
            "identifier": "786679",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "casey.mraz.1@3522.direct.athenahealth.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "3415 N Loop 250 W Bldg 4",
            "city": "Midland",
            "state": "TX",
            "country_code": "US",
            "postal_code": "797076034",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Midland, TX

Sources for this page

Verify at the official NPI Registry.