Individual provider Active NPI

Daryl John Magoulick, CRNA

  • Certified Registered Nurse Anesthetist
  • Waco, TX
National Provider Identifier
1689766024
Registry record updated Jan 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
635517 Issued in TX
Practice address
100 Hillcrest Medical Blvd
Waco, TX 76712-8897
Phone
(254) 202-2000
NPI assigned
Sep 29, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2022

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 127966 TN
Certified Registered Nurse Anesthetist 367500000X 107747 KY
Certified Registered Nurse Anesthetist 367500000X 2976A KY
Certified Registered Nurse Anesthetist 367500000X 635517 TX Primary

Addresses

Primary practice location

100 Hillcrest Medical Blvd
Waco, TX 76712-8897

Mailing address

PO Box 844658
Dallas, TX 75284-4658
Phone (254) 724-2111

Other practice location 1

36000 Darnall Loop
Anesthesia Department
Fort Hood, TX 76544
Phone (254) 288-8570

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address dmagoulick32824@direct.sw.org Direct

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040420001768 TX Practitioner - Certified Registered Nurse Anesthetist (Crna) 8921094681 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Scott and White ClinicGroup PAC ID 8123923604, 2,426 clinicians
Northstar Anesthesia PAGroup PAC ID 7315907128, 231 clinicians

Practice addresses (Care Compare)

1815 S 31St St
Baylor Scott and White Pavilion Temple
Temple, TX 76504-6728
Phone (254) 724-2111

2201 Clear Creek Rd
Killeen, TX 76549-4110
Phone (254) 526-7523

6200 W Parker Rd
Plano, TX 75093-7939
Phone (972) 608-8000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
107747KYMDCertified Registered Nurse Anesthetist
2976AKYMDCertified Registered Nurse Anesthetist
127966TNMDCertified Registered Nurse Anesthetist
635517TXMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
NTX Anesthesiology Consultants PLLC CurrentSince Mar 21, 2019 Accepting new patients
Scott & White Clinic Current Accepting new patients
Scott & White Clinic CurrentSince Jan 1, 2016 Accepting new patients
Northstar Anesthesia, PA Nurse Anesthetist, Certified Registered CurrentSince Aug 3, 2023 Accepting new patients
Integrated Pain Associates PLLC CurrentSince Apr 2, 2018 Accepting new patients
Integrated Pain Associates PLLC CurrentSince Apr 2, 2018 Accepting new patients
Scott and White Clinic CurrentSince Jan 1, 2016 Accepting new patients
Amarillo Anesthesia Consultants PA Nurse Anesthetist, Certified Registered Past Accepting new patients
Scott & White Hospital - Taylor Past Accepting new patients
Hendrick Anesthesia Network Past Accepting new patients

Locations

101 E Jackson St
Burnet, TX 78611
Phone (512) 756-7510

101 Lafferty Ave
Cameron, TX 76520
Phone (254) 605-1100

909 9th Ave
Ft Worth, TX 76104
Phone (817) 336-6060

1917 Ashland St
Houston, TX 77008
Phone (713) 861-6161

2201 Clear Creek Rd
Killeen, TX 76549
Phone (254) 519-8185

3800 S W S Young Dr
Ste 201
Killeen, TX 76542
Phone (254) 213-0489

200 W Ollie St
Llano, TX 78643
Phone (325) 216-9199

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

2221 Lakeside Blvd
Ste 600
Richardson, TX 75082
Phone (469) 998-7450

546 N Kegley Rd
Temple, TX 76502
Phone (254) 215-0900

2401 S 31st St
Temple, TX 76508
Phone (254) 724-2459

1815 S 31st St
Temple, TX 76504
Phone (254) 215-9523

100 Hillcrest Medical Blvd
Waco, TX 76712
Phone (254) 202-2000

2400 N Interstate Highway 35 E
Waxahachie, TX 75165
Phone (469) 843-4000

Organizations & group practices 10

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.

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": "1159488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643241600000",
    "number": "1689766024",
    "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": "254-724-2111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 HILLCREST MEDICAL BLVD",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767128897",
            "telephone_number": "254-202-2000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "36000 Darnall Loop",
            "address_2": "Anesthesia Department",
            "address_purpose": "LOCATION",
            "city": "Fort Hood",
            "state": "TX",
            "postal_code": "76544",
            "country_code": "US",
            "telephone_number": "254-288-8570",
            "fax_number": "254-286-7017",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAGOULICK",
        "first_name": "DARYL",
        "middle_name": "JOHN",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-29",
        "last_updated": "2022-01-27",
        "certification_date": "2022-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TN",
            "license": "127966",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "KY",
            "license": "107747",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "KY",
            "license": "2976A",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "635517",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dmagoulick32824@direct.sw.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "100 Hillcrest Medical Blvd",
            "city": "Waco",
            "state": "TX",
            "country_code": "US",
            "postal_code": "767128897",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Waco, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 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.