Individual provider Active NPI

Bryan Timothy Pernes, AA-S

  • Anesthesiologist Assistant
  • Houston, TX
National Provider Identifier
1972966596
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiologist AssistantTaxonomy code 367H00000X
License
4014 Issued in TX
Practice address
1500 Citywest Blvd Ste 300
Houston, TX 77042-2549
Phone
(713) 620-4000
Fax
(713) 458-4229
NPI assigned
Mar 31, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiologist Assistant 367H00000X AA338 FL
Anesthesiologist Assistant 367H00000X 2016017066 MO
Anesthesiologist Assistant 367H00000X 4014 TX Primary

Addresses

Primary practice location

1500 Citywest Blvd Ste 300
Houston, TX 77042-2549

Mailing address

PO Box 650865
Dallas, TX 75265-0865
Phone (972) 233-1999

Other practice location 1

8900 N Kendall Dr
Dept. of Anesthesiology
Miami, FL 33176-2118
Phone (786) 596-3621

Other practice location 2

8900 N Kendall Dr
Dept. of Anesthesiology
Miami, FL 33176-2118
Phone (786) 596-3621

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190619003816 SC Practitioner - Anesthesiology Assistant 1557653003 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Atlantic Coast Anesthesia Services PCGroup PAC ID 3971887167, 71 clinicians

Practice addresses (Care Compare)

809 82ND Pkwy
Myrtle Beach, SC 29572-4607
Phone (843) 692-1000

Hospital & facility affiliations

  • Grand Strand Regional Medical Center Hospital, Myrtle Beach, SC, CCN 420085

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
58SCMDMarriage & Family Therapist
AA338FLMDAnesthesiologist Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Beach Anesthesia, LLC CurrentSince Aug 28, 2018 Accepting new patients
Atlantic Coast Anesthesia Services P.C. CurrentSince Jun 1, 2020 Accepting new patients

Locations

109 Blarney Dr
Columbia, SC 29223
Phone (803) 865-8200

2000 Hospital Dr
Mt Pleasant, SC 29464
Phone (803) 533-2200

809 82nd Pkwy
Myrtle Beach, SC 29572
Phone (843) 291-7182

1021 Cipriana Dr
Ste 100
Myrtle Beach, SC 29572
Phone (843) 449-7885

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": "1459382400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1972966596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 650865",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752650865",
            "telephone_number": "972-233-1999",
            "fax_number": "972-233-3666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 CITYWEST BLVD STE 300",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770422549",
            "telephone_number": "713-620-4000",
            "fax_number": "713-458-4229"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8900 N Kendall Dr",
            "address_2": "Dept. of Anesthesiology",
            "address_purpose": "LOCATION",
            "city": "Miami",
            "state": "FL",
            "postal_code": "331762118",
            "country_code": "US",
            "telephone_number": "786-596-3621",
            "fax_number": "786-596-2841",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8900 N Kendall Dr",
            "address_2": "Dept. of Anesthesiology",
            "address_purpose": "LOCATION",
            "city": "Miami",
            "state": "FL",
            "postal_code": "331762118",
            "country_code": "US",
            "telephone_number": "786-596-3621",
            "fax_number": "786-596-2841",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PERNES",
        "first_name": "BRYAN",
        "middle_name": "TIMOTHY",
        "credential": "AA-S",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-03-31",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367H00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiologist Assistant",
            "state": "FL",
            "license": "AA338",
            "primary": false
        },
        {
            "code": "367H00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiologist Assistant",
            "state": "MO",
            "license": "2016017066",
            "primary": false
        },
        {
            "code": "367H00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiologist Assistant",
            "state": "TX",
            "license": "4014",
            "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 Mar 17, 2018; 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.