Unknown Individual – Anesthesiology Physician, NPI 1386649184
Anesthesiology Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for Unknown Individual
Bedrock Counseling, 3300, Oak Lawn Avenue, Oak Lawn, Dallas, TX, Dallas, Dallas County, Texas, 75219, United States
SUITE 200
DALLAS, TX 752194236
Phone: (214) 252-3501
Type: Mailing
2221 LAKESIDE BLVD
STE 600
RICHARDSON, TX 750824236
Phone: (855) 285-2455
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 5 Medicare enrollment records; no due dates published yet.
Enrollment records
5
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20060301000263 | I | Anesthesiology | TX | TBD |
| I20190617002798 | I | Anesthesiology | AZ | TBD |
| I20200714002626 | I | Anesthesiology | NV | TBD |
| I20201019000282 | I | Anesthesiology | UT | TBD |
| I20240212002356 | I | Anesthesiology | OK | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 75219)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Certified Registered Nurse Anesthetist (Crna) | TX | |
| Certified Registered Nurse Anesthetist (Crna) | TX | |
| Certified Registered Nurse Anesthetist (Crna) | TX | |
| Pain Management, Anesthesiology | TX | |
| Anesthesiology, Pain Management | TX | |
| A N E S T H E S I O L O G Y | TX | |
| - | TX | |
| A N E S T H E S I O L O G Y | TX | |
| Certified Registered Nurse Anesthetist (Crna) | TX | |
| Certified Registered Nurse Anesthetist (Crna) | TX |
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