Individual provider Active NPI

Ashley Mazur, CRNA

  • Certified Registered Nurse Anesthetist
  • Fort Worth, TX
National Provider Identifier
1689810509
Registry record updated Dec 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
696207 Issued in TX
Practice address
1300 Pennsylvania Ave
Fort Worth, TX 76104-2111
Phone
(972) 715-5007
Fax
(972) 715-5682
NPI assigned
Dec 23, 2008
Last updated
Dec 23, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2008

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 696207 TX Primary

Addresses

Primary practice location

1300 Pennsylvania Ave
Fort Worth, TX 76104-2111

Mailing address

PO Box 650426
Dallas, TX 75265-0426
Phone (972) 715-5007

Other identifiers 2

IdentifierTypeStateIssuer
081145OtherTXCRNA CERTIFICATE
696207OtherTXSTATE LICENSE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090204000573 TX Practitioner - Certified Registered Nurse Anesthetist (Crna) 0648334722 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Endo Sedation LLCGroup PAC ID 4789845363, 289 clinicians

Practice addresses (Care Compare)

180 Bear Creek Pkwy
Keller, TX 76248-2500
Phone (817) 337-3671

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
696207TXMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Sound Physicians Anesthesiology of Texas PLLC CurrentSince Mar 1, 2021 Accepting new patients
Endo Sedation LLC Nurse Anesthetist, Certified Registered CurrentSince Jun 1, 2018 Accepting new patients
Endo Sedation LLC Nurse Anesthetist, Certified Registered CurrentSince Jun 1, 2018 Accepting new patients
Endo Sedation LLC Nurse Anesthetist, Certified Registered Current Accepting new patients
Cowtown Anesthesia Serivces, L.L.P. Nurse Anesthetist, Certified Registered CurrentSince Sep 6, 2014 Accepting new patients

Locations

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

6317 Harris Pkwy
Ste 100
Fort Worth, TX 76132
Phone (817) 332-6500

1500 S Main St
Ft Worth, TX 76104
Phone (817) 921-3431

2001 W Rosedale St
Ft Worth, TX 76104
Phone (817) 877-4777

701 Tuscan Dr
Ste 100
Irving, TX 75039
Phone (214) 496-1100

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

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

550 Reserve St
Ste 560
Southlake, TX 76092

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1229990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1229990400000",
    "number": "1689810509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 650426",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752650426",
            "telephone_number": "972-715-5007",
            "fax_number": "972-715-5682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 PENNSYLVANIA AVE",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761042111",
            "telephone_number": "972-715-5007",
            "fax_number": "972-715-5682"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAZUR",
        "first_name": "ASHLEY",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-12-23",
        "last_updated": "2008-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "696207",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CRNA CERTIFICATE",
            "identifier": "081145",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "696207",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 Dec 23, 2008; 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.