Individual provider Active NPI

Maryna A Kovalchuk, CAA

  • Anesthesiologist Assistant
  • Houston, TX
National Provider Identifier
1972342970
Registry record updated May 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiologist AssistantTaxonomy code 367H00000X
Practice address
6720 Bertner Ave
Houston, TX 77030-2604
Phone
(832) 355-2666
NPI assigned
May 21, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiologist Assistant 367H00000X Primary

Addresses

Primary practice location

6720 Bertner Ave
Houston, TX 77030-2604

Mailing address

6720 Bertner Ave Ste O-520
Houston, TX 77030-2604
Phone (832) 355-2666

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240609000051 TX Practitioner - Anesthesiology Assistant 5698217420 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Baylor College of MedicineGroup PAC ID 8022243971, 1,230 clinicians

Practice addresses (Care Compare)

6720 Bertner Ave
Houston, TX 77030-2604
Phone (713) 798-1000

Hospital & facility affiliations

  • Baylor St Lukes Medical Center Hospital, Houston, TX, CCN 450193

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Associate of Arts, Master of Science

Practice roles

OrganizationSpecialtyStatusNew patients
Baylor College of Medicine CurrentSince Jun 1, 2024 Accepting new patients
Baylor College of Medicine CurrentSince Jun 1, 2024 Accepting new patients

Locations

6720 Bertner Ave
Ste O520
Houston, TX 77030
Phone (832) 355-2202

7200 Cambridge St
Fl 1
Houston, TX 77030
Phone (713) 798-3924

17450 St Lukes Way
Ste 340
The Woodlands, TX 77384
Phone (936) 266-2645

6720 Bertner Ave
Va Hospital, TX 77030
Phone (713) 785-8537

Organizations & group practices 2

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1716249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716249600000",
    "number": "1972342970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6720 BERTNER AVE STE O-520",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770302604",
            "telephone_number": "832-355-2666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6720 BERTNER AVE",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770302604",
            "telephone_number": "832-355-2666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOVALCHUK",
        "first_name": "MARYNA",
        "middle_name": "A",
        "credential": "CAA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-05-21",
        "last_updated": "2024-05-21",
        "certification_date": "2024-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367H00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiologist Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2024; 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.