Individual provider Active NPI

Jesus Flores, CRNA

  • Certified Registered Nurse Anesthetist
  • Tacoma, WA
National Provider Identifier
1831241991
Registry record updated Mar 20, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
621169 Issued in TX
Practice address
9040 Jackson Ave
Tacoma, WA 98431-1100
Phone
(253) 968-2235
NPI assigned
Jan 17, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 20, 2014

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 621169 TX Primary

Addresses

Primary practice location

9040 Jackson Ave
Tacoma, WA 98431-1100

Mailing address

9210 S Hosmer St Apt A3
Tacoma, WA 98444-6860
Phone (210) 379-6696

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151006001158 TX Practitioner - Certified Registered Nurse Anesthetist (Crna) 9739497074 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eagle Anesthesia PLLCGroup PAC ID 5092083998, 11 clinicians

Practice addresses (Care Compare)

811 S Central Expy
Suite 103
Richardson, TX 75080-7439
Phone (972) 636-5727

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
621169TXMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Endo Sedation LLC Nurse Anesthetist, Certified Registered CurrentSince Jul 1, 2021 Accepting new patients
Val Verde Hospital Corporation CurrentSince Jul 27, 2015 Accepting new patients
Endo Sedation LLC Nurse Anesthetist, Certified Registered CurrentSince Jul 1, 2021 Accepting new patients
Endo Sedation LLC Nurse Anesthetist, Certified Registered Current Accepting new patients
Westover Anesthesia Services PLLC Nurse Anesthetist, Certified Registered CurrentSince May 24, 2019 Accepting new patients
Val Verde Hospital Corporation Nurse Anesthetist, Certified Registered CurrentSince Jul 27, 2015 Accepting new patients
Eagle Anesthesia PLLC CurrentSince Aug 20, 2019 Accepting new patients

Locations

801 N Bedell Ave
Del Rio, TX 78840
Phone (830) 703-1702

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

811 S Central Expy
Ste 103
Richardson, TX 75080
Phone (972) 310-7121

1314 E Sonterra Blvd
Ste 2107
San Antonio, TX 78258

702 Richland Hills Dr
Unit 761960
San Antonio, TX 78245

855 Proton Rd
San Antonio, TX 78258
Phone (210) 582-8000

5223 Hamilton Wolfe Rd
San Antonio, TX 78229
Phone 2106141234713

Organizations & group practices 8

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": "1168992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395273600000",
    "number": "1831241991",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9210 S HOSMER ST APT A3",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984446860",
            "telephone_number": "210-379-6696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9040 JACKSON AVE",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984311100",
            "telephone_number": "253-968-2235"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLORES",
        "first_name": "JESUS",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-17",
        "last_updated": "2014-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "621169",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tacoma, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2014; 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.