Individual provider Active NPI

John Madison Cary Sr., CRNA

  • Certified Registered Nurse Anesthetist
  • Dallas, TX
National Provider Identifier
1790762193
Registry record updated Oct 24, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
693338 Issued in TX
Practice address
4344 Fairfax Ave
Dallas, TX 75205-3027
Phone
(214) 557-5597
NPI assigned
Dec 27, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 24, 2015

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 693338 TX Primary

Addresses

Primary practice location

4344 Fairfax Ave
Dallas, TX 75205-3027

Mailing address

4344 Fairfax Ave
Dallas, TX 75205-3027
Phone (214) 557-5597

Other identifiers 5

IdentifierTypeStateIssuer
P00059390OtherTXRAILROAD
1572273-04MedicaidTX
157227302MedicaidTX
83216UOtherTXBCBS
8937UBOtherTXBCBSTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV, NC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20180221000024 NV Practitioner - Certified Registered Nurse Anesthetist (Crna) 9638169121 Reassigns benefits to 2 organizations
I20190211002258 NC Practitioner - Certified Registered Nurse Anesthetist (Crna) 9638169121 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Digestive Health AssociatesGroup PAC ID 0547247082, 38 clinicians

Practice addresses (Care Compare)

655 Sierra Rose Dr
Reno, NV 89511-2060
Phone (775) 829-7600

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
693338TXMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Gastroenterology Consultants, LTD CurrentSince Feb 1, 2018 Accepting new patients
Prime Healthcare Services - Reno LLC Past Accepting new patients
Northeastern Anesthesia Physicians P.C. Past Accepting new patients
Renown Regional Medical Center Past Accepting new patients
Amarillo Anesthesia Consultants PA Nurse Anesthetist, Certified Registered Past Accepting new patients

Locations

880 Ryland St
Reno, NV 89502
Phone (775) 329-4600

Organizations & group practices 7

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": "1135641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1445644800000",
    "number": "1790762193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4344 FAIRFAX AVE",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752053027",
            "telephone_number": "214-557-5597"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4344 FAIRFAX AVE",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752053027",
            "telephone_number": "214-557-5597"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARY",
        "first_name": "JOHN",
        "middle_name": "MADISON",
        "name_prefix": "Mr.",
        "name_suffix": "Sr.",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-12-27",
        "last_updated": "2015-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "693338",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD",
            "identifier": "P00059390",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1572273-04",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "157227302",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "83216U",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSTX",
            "identifier": "8937UB",
            "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 Oct 24, 2015; 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.