Individual provider Active NPI

Angela M Brewer, CRNA

  • Certified Registered Nurse Anesthetist
  • Fort Worth, TX
National Provider Identifier
1790444776
Registry record updated Nov 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
133949 Issued in TX
Practice address
1575 S Main St
Fort Worth, TX 76104-4901
Phone
(817) 702-3431
NPI assigned
Dec 16, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 29, 2023

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 133949 TX Primary

Addresses

Primary practice location

1575 S Main St
Fort Worth, TX 76104-4901

Mailing address

1808 Creek Bend Dr
Corinth, TX 76208-5180
Phone (940) 808-8626

Other names 1

  • Angela A Mazzitelli Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220411001870 TX Practitioner - Certified Registered Nurse Anesthetist (Crna) 1658767074 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2021
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)

1001 Surrey LN
Flower Mound, TX 75022-4234
Phone (817) 337-3671

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
133949TXMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Sound Physicians Anesthesiology of Texas PLLC CurrentSince Jan 13, 2022 Accepting new patients
Endo Sedation LLC Nurse Anesthetist, Certified Registered CurrentSince Jan 12, 2025 Accepting new patients
Endo Sedation LLC Nurse Anesthetist, Certified Registered CurrentSince Jan 12, 2025 Accepting new patients
Premier Anesthesia of Huntsville a Division of Premier Anesthesia LLC Nurse Anesthetist, Certified Registered CurrentSince Jul 31, 2023 Accepting new patients

Locations

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

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

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

5501 S Expressway 77
Harlingen, TX 78550
Phone (936) 569-9481

1401 St Joseph Pkwy
Houston, TX 77002
Phone (713) 575-1000

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

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

515 S Nolen Dr
Southlake, TX 76092
Phone (817) 912-1999

1401 E 8th St
Weslaco, TX 78596
Phone (956) 581-0303

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.

NPI Registry JSON

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

{
    "created_epoch": "1639612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701216000000",
    "number": "1790444776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1808 CREEK BEND DR",
            "city": "CORINTH",
            "state": "TX",
            "postal_code": "762085180",
            "telephone_number": "940-808-8626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1575 S MAIN ST",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761044901",
            "telephone_number": "817-702-3431"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BREWER",
        "first_name": "ANGELA",
        "middle_name": "M",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-12-16",
        "last_updated": "2023-11-29",
        "certification_date": "2023-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "133949",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANGELA",
            "last_name": "MAZZITELLI",
            "middle_name": "A",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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 Nov 29, 2023; 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.