NPIMap

Organization Active NPI

Modern Anesthesia Associates

  • Certified Registered Nurse Anesthetist
  • Houston, TX
National Provider Identifier
1679345045
Registry record updated Apr 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
Legal business name
MODERN ANESTHESIA ASSOCIATES
Practice address
800 Wilcrest Dr Ste 213
Houston, TX 77042-1360
Phone
(713) 993-6053
Fax
(866) 810-8005
NPI assigned
Oct 27, 2023
Last updated
Apr 30, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2025

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

Authorized official

Name
David Profit Jr.NPI 1699035923
Title
Ceo
Phone
(713) 993-6053

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 1

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

Addresses

Primary practice location

800 Wilcrest Dr Ste 213
Houston, TX 77042-1360

Mailing address

PO Box 66791
Houston, TX 77266-6791
Phone (713) 993-6053

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240118004058 TX Part B Supplier - Clinic/Group Practice 0244682813 Receives reassigned benefits from 17 practitioners
Practice locations: Sugar Land, TX; Victoria, TX; The Woodlands, TX; Shenandoah, TX; Pasadena, TX; Kingwood, TX; Houston, TX; Corpus Christi, TX…

National Provider Directory

National Provider Directory

Locations

12825 Gulf Fwy
Houston, TX 77034
Phone (713) 955-1707

3412 Burke Rd
#100
Pasadena, TX 77504

17183 I 45 S
Ste 350
Shenandoah, TX 77385
Phone (936) 321-0080

25329 Budde Rd
Ste 202
The Woodlands, TX 77380
Phone (325) 851-5008

Practitioners & affiliated clinicians

Practitioners 17

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 17

NPI Registry JSON

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

{
    "created_epoch": "1698364800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1745971200000",
    "number": "1679345045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 66791",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "772666791",
            "telephone_number": "713-993-6053",
            "fax_number": "866-810-8005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 WILCREST DR STE 213",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770421360",
            "telephone_number": "713-993-6053",
            "fax_number": "866-810-8005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MODERN ANESTHESIA ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-27",
        "last_updated": "2025-04-30",
        "certification_date": "2025-04-30",
        "status": "A",
        "authorized_official_last_name": "PROFIT",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "713-993-6053",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2025; 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.