Mackenzie D Sullivan (NPI# 1023525532, PAC ID# 6204196314) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA).
| Nation Provider ID (NPI) | 1023525532 |
| PAC ID by PECOS | 6204196314 |
| Professional Enrollment ID | I20180212000450 |
| Full Name | Mackenzie D Sullivan |
| Organization Legal Name | STAR ANESTHESIA, P.A. |
| Address |
3510 N Loop 1604 San Antonio TX 78247-2303 |
| Phone Number | 2103757790 |
| Gender | F |
| Graduation Year | 2017 |
| Primary Specialty | CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA) |
| Group Practice PAC ID | 6204736812 |
| Number of Group Practice Members | 271 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 450237 | CHRISTUS SANTA ROSA MEDICAL CENTER |
| 450130 | NIX HEALTH CARE SYSTEM |
| Address | Phone | Organization |
|---|---|---|
| 11212 Hwy 151, San Antonio, TX 78251-4498 | 2107038000 | U S ANESTHESIA PARTNERS OF TEXAS, PA |
| 3510 N Loop 1604, San Antonio, TX 78247-2303 | 2103757790 | STAR ANESTHESIA, P.A. |
| 9250 Pinecroft Dr, Shenandoah, TX 77380-3218 | 7136204000 | U S ANESTHESIA PARTNERS OF TEXAS, PA |
| Organization Legal Name | STAR ANESTHESIA, P.A. |
| Physicians | 143 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Henry H Herrera | Anesthesiology | Star Anesthesia, P.a. | 45 Ne Loop, Suite 900, San Antonio, TX 78216 |
| Anupama Gotimukula | Anesthesiology | Star Anesthesia, P.a. | 3510 N Loop 1604, San Antonio, TX 78247-2303 |
| Keith Neal Sumner | Anesthesiology | Star Anesthesia, P.a. | 3510 N Loop 1604, San Antonio, TX 78247-2303 |
| Daniel Price | Anesthesiology Assistant | Star Anesthesia, P.a. | 3510 N Loop 1604, San Antonio, TX 78247-2303 |
| Tara S Frost | Anesthesiology | Star Anesthesia, P.a. | 3510 N Loop 1604, San Antonio, TX 78247-2303 |
| Betty Jon Healy | Anesthesiology | Star Anesthesia, P.a. | 3510 N Loop 1604, San Antonio, TX 78247-2303 |
| Emily Eilers | Anesthesiology | Star Anesthesia, P.a. | 3510 N Loop 1604, San Antonio, TX 78247-2303 |
| Philip E Garcia | Anesthesiology | Star Anesthesia, P.a. | 3510 N Loop 1604, San Antonio, TX 78247-2303 |
| Brian M Fitzgerald | Anesthesiology | Star Anesthesia, P.a. | 3510 N Loop 1604, San Antonio, TX 78247-2303 |
| Vijayendra Mishra | Anesthesiology | Star Anesthesia, P.a. | 3510 N Loop 1604, San Antonio, TX 78247-2303 |
| Street Address |
3510 N LOOP 1604 |
| City | SAN ANTONIO |
| State | TX |
| Zip | 78247-2303 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Anupama Gotimukula | Anesthesiology | Star Anesthesia, P.a. | 3510 N Loop 1604, San Antonio, TX 78247-2303 |
| Keith Neal Sumner | Anesthesiology | Star Anesthesia, P.a. | 3510 N Loop 1604, San Antonio, TX 78247-2303 |
| Daniel Price | Anesthesiology Assistant | Star Anesthesia, P.a. | 3510 N Loop 1604, San Antonio, TX 78247-2303 |
| Tara S Frost | Anesthesiology | Star Anesthesia, P.a. | 3510 N Loop 1604, San Antonio, TX 78247-2303 |
| Betty Jon Healy | Anesthesiology | Star Anesthesia, P.a. | 3510 N Loop 1604, San Antonio, TX 78247-2303 |
| Emily Eilers | Anesthesiology | Star Anesthesia, P.a. | 3510 N Loop 1604, San Antonio, TX 78247-2303 |
| Philip E Garcia | Anesthesiology | Star Anesthesia, P.a. | 3510 N Loop 1604, San Antonio, TX 78247-2303 |
| Brian M Fitzgerald | Anesthesiology | Star Anesthesia, P.a. | 3510 N Loop 1604, San Antonio, TX 78247-2303 |
| Vijayendra Mishra | Anesthesiology | Star Anesthesia, P.a. | 3510 N Loop 1604, San Antonio, TX 78247-2303 |
| Anthony Elmore Clark | Anesthesiology | Star Anesthesia, P.a. | 3510 N Loop 1604, San Antonio, TX 78247-2303 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Chad E Wersell | Chiropractic | 15150 Nacogdoches Rd, 185 Nacogdoches Chiro, San Antonio, TX 78247-1201 | |
| Brenda Saucedo | Nurse Practitioner | Wellmed Medical Group Pa | 14100 Nacogdoches Rd, 116 Wellmed At Northern Hills, San Antonio, TX 78247-1907 |
| Jyothi Kundur | Family Medicine | Wellmed Medical Group Pa | 14100 Nacogdoches Rd, 116 Wellmed At Northern Hills, San Antonio, TX 78247-1907 |
| Kristopher Koch | Internal Medicine | Wellmed Medical Group Pa | 14100 Nacogdoches Rd, 116 Wellmed At Northern Hills, San Antonio, TX 78247-1907 |
| William Copp Newall Iii | Nurse Practitioner | Wellmed Medical Group Pa | 14100 Nacogdoches Rd, 116 Wellmed At Northern Hills, San Antonio, TX 78247-1907 |
| Shamsa Saleem | Family Medicine | Wellmed Medical Group Pa | 14100 Nacogdoches Rd, 116 Wellmed At Northern Hills, San Antonio, TX 78247-1907 |
| Raul Martinez | Family Medicine | Wellmed Medical Group Pa | 14100 Nacogdoches Rd, 116 Wellmed At Northern Hills, San Antonio, TX 78247-1907 |
| Clarence M Porter | Family Practice | Wellmed Medical Group, P.a. | 14100 Nacogdoches Rd, 116 Wellmed At Northern Hills, San Antonio, TX 78247-1907 |
| Eric D Delgado | Optometry | 14016 Nacogdoches Rd, San Antonio, TX 78247-1929 | |
| Haley Swift | Optometry | 17230 Autry Pond Rd, Suite 104, San Antonio, TX 78247-2067 | |
| Find all physicians in zip 78247 | |||
| City | SAN ANTONIO |
| Zip Code | 78247 |
| Specialty | CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA) |
| City + Specialty | SAN ANTONIO + CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA) |
Please comment or provide details below to improve the information on Mackenzie D Sullivan.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.