Organization Active NPI

NNKS Anesthesia LLC

  • Anesthesiology Physician
  • Phoenix, AZ
National Provider Identifier
1063134500
Registry record updated Sep 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
NNKS ANESTHESIA LLC
Practice address
16620 North 40TH Street
Suite D-1
Phoenix, AZ 85032
Phone
(602) 800-9380
NPI assigned
Sep 12, 2022
Last updated
Sep 12, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2022

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

Authorized official

Name
Martha Hernandez
Title
Director
Phone
(602) 800-9380

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X NU Primary

Addresses

Primary practice location

16620 North 40TH Street
Suite D-1
Phoenix, AZ 85032

Mailing address

16620 North 40TH Street
Suite D-1
Phoenix, AZ 85032
Phone (602) 800-9380

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230601001439 AZ Part B Supplier - Clinic/Group Practice 5597122838 Receives reassigned benefits from 1 practitioner
Practice locations: Phoenix, AZ; Scottsdale, AZ

National Provider Directory

National Provider Directory

Locations

16620 N 40th St
Ste D1
Phoenix, AZ 85032
Phone (480) 565-7246

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1662940800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1662940800000",
    "number": "1063134500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16620 NORTH 40TH STREET",
            "address_2": "SUITE D-1",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "85032",
            "telephone_number": "602-800-9380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16620 NORTH 40TH STREET",
            "address_2": "SUITE D-1",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "85032",
            "telephone_number": "602-800-9380"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NNKS ANESTHESIA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-12",
        "last_updated": "2022-09-12",
        "certification_date": "2022-09-12",
        "status": "A",
        "authorized_official_last_name": "HERNANDEZ",
        "authorized_official_first_name": "MARTHA",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "602-800-9380"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.