CCMMA TX PLLC – Anesthesiology Physician, NPI 1841829819
Anesthesiology Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for CCMMA TX PLLC
1 MEDICAL PLAZA
PAMPA, TX 790657906
Phone: (806) 665-3721
Type: Location
18220 State Highway 249
Houston, TX 770704347
Phone: (281) 737-1000
Type: Location
McKenzie Health System 120 Delaware Street
Sandusky, MI 484711087
Phone: (810) 648-3770
Fax: (888) 220-6560
Type: Location
EAST LIVERPOOL CITY HOSPITAL 425 W 5TH STREET
EAST LIVERPOOL, OH 439202405
Phone: (330) 385-7200
Fax: (888) 220-6560
Type: Location
17201 Interstate 45 S
Shenandoah, TX 773853311
Phone: (936) 270-2000
Type: Location
PALMETTO TUOMEY 129 No Washington St
Sumter, SC 291504949
Phone: (803) 774-9000
Fax: (888) 220-6560
Type: Location
224 W 18TH ST APT 8A
NEW YORK, NY 100114558
Phone:
Type: Mailing
PO BOX 631801
CINCINNATI, OH 452631801
Phone: (845) 702-2711
Type: Mailing
2 PARK AVE STE 2039
NEW YORK, NY 100165675
Phone: (845) 702-2711
Type: Location
ST. MARY'S MEDICAL CENTER 201 NW R D Mize Rd
Blue Springs, MO 640142513
Phone: (816) 228-5900
Fax: (888) 220-6560
Type: Location
St Mary's General Hospital 350 Boulevard
Passaic, NJ 070552840
Phone: (973) 365-4300
Fax: (888) 220-6560
Type: Location
21900 Farmington Rd
Farmington, MI 483364443
Phone: (845) 702-2711
Fax: (888) 220-6560
Type: Location
224 W 18th St Apt 8A
New York, NY 100114558
Phone: (914) 523-2189
Type: Location
5902 Manning Hollow Ln
Sugar Land, TX 774794904
Phone: (845) 702-2711
Fax: (888) 220-6560
Type: Location
Integris Bass Baptist Health Center 600 S. Monroe St.
ENID, OK 737017211
Phone: (580) 233-2300
Fax: (888) 220-6560
Type: Location
701 S Fry Rd
Katy, TX 774502255
Phone: (832) 522-7550
Type: Location
18500 Katy Fwy
Houston, TX 770941110
Phone: (832) 522-1000
Type: Location
16555 Southwest Fwy
Sugar Land, TX 774792668
Phone: (281) 274-7000
Type: Location
4401 Garth Rd
Baytown, TX 775212122
Phone: (281) 420-8600
Type: Location
18300 Houston Methodist Dr
Houston, TX 770586302
Phone: (281) 523-2000
Type: Location
6565 Fannin St
Houston, TX 770302703
Phone: (713) 790-3311
Type: Location
6565 FANNIN ST
HOUSTON, TX 770302703
Phone: (713) 790-3311
Type: Location
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.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2023-12-27
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Past revalidation due date
Earliest CMS due date was 2025-11-30 (191 days ago).
Enrollment records
3
Earliest due date
2025-11-30
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 |
|---|---|---|---|---|
| O20200408002929 | O | Clinic/Group Practice | TX | 2025-11-30 |
| O20210215000556 | O | Clinic/Group Practice | CA | 2026-05-31 |
| O20231227000470 | O | Clinic/Group Practice | MI | TBD |
What to do next
- Verify current status on the CMS Revalidation Lookup Tool immediately.
- Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
- Overdue revalidation can lead to deactivation of Medicare billing privileges.
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 79065)
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