Active NPI
Marlet L Constantino, CRNA
- Certified Registered Nurse Anesthetist
- Dallas, TX
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 728503
- Practice address
- 13737 Noel Rd
Ste 1400
Dallas, TX 75240-2004 - Phone
- (972) 715-5000
- Fax
- (972) 715-9976
- NPI assigned
- Jan 19, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | 728503 | TX | Primary |
Addresses
Primary practice location
13737 Noel Rd
Ste 1400
Dallas, TX 75240-2004
Mailing address
PO Box 650426
Dallas, TX 75265-0426
Phone (972) 715-5000
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 296828102 | Medicaid | TX | |
| 8972UD | Other | TX | BCBS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- Other, 2011
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2704 N Galloway Ave
Suite 102
Mesquite, TX 75150-6379
Phone (972) 961-7171
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 728503 | TX | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Endo Sedation LLC | Nurse Anesthetist, Certified Registered | Current | Accepting new patients |
| Endo Sedation LLC | Nurse Anesthetist, Certified Registered | Current | Accepting new patients |
| Endo Sedation LLC | Nurse Anesthetist, Certified Registered | Current | Accepting new patients |
| Pinnacle Anesthesia Consultants, PLLC | Nurse Anesthetist, Certified Registered | Past | Accepting new patients |
Locations
1001 Surrey Ln
Flower Mound, TX 75022
Phone (817) 337-3671
180 Bear Creek Pkwy
Keller, TX 76248
Phone (817) 337-3671
2704 N Galloway Ave
Ste 102
Mesquite, TX 75150
Phone (972) 961-7171
Organizations & group practices 4
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.
-
- Certified Registered Nurse Anesthetist
- Keller, TX
- NPI 1588931174
Nurse Anesthetist, Certified Registered
-
- Certified Registered Nurse Anesthetist
- Flower Mound, TX
- NPI 1114270931
Nurse Anesthetist, Certified Registered
-
- Certified Registered Nurse Anesthetist
- Beaumont, TX
- NPI 1548817471
Nurse Anesthetist, Certified Registered
-
- Anesthesiology Physician
- Dallas, TX
- NPI 1457342297
Nurse Anesthetist, Certified Registered
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1326931200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1379548800000",
"number": "1699046979",
"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": "972-715-5000",
"fax_number": "972-715-9976"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13737 NOEL RD",
"address_2": "STE 1400",
"city": "DALLAS",
"state": "TX",
"postal_code": "752402004",
"telephone_number": "972-715-5000",
"fax_number": "972-715-9976"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CONSTANTINO",
"first_name": "MARLET",
"middle_name": "L",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-01-19",
"last_updated": "2013-09-19",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "TX",
"license": "728503",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "296828102",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "8972UD",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Dallas, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2013; 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.