Individual provider Active NPI

Juancho C. Depaolo, CRNA

  • Certified Registered Nurse Anesthetist
  • Mesa, AZ
National Provider Identifier
1063439834
Registry record updated Apr 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
CRNA0791 Issued in AZ
Practice address
1301 S Crismon Rd
Mesa, AZ 85209-3767
Phone
(800) 402-0881
NPI assigned
Jul 16, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 25, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X CRNA0791 AZ Primary

Addresses

Primary practice location

1301 S Crismon Rd
Mesa, AZ 85209-3767

Mailing address

21215 E Vallejo St
Queen Creek, AZ 85142-5332
Phone (407) 864-0420

Other identifiers 3

IdentifierTypeStateIssuer
3038203 00MedicaidFL
G2859OtherFLBCBS
G2859POtherFLMEDICARE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111201000232 AZ Practitioner - Certified Registered Nurse Anesthetist (Crna) 1557355682 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Greater Anesthesia SolutionsGroup PAC ID 9234357906, 210 clinicians
Northwest HBP Medical Services LLCGroup PAC ID 8921356536, 278 clinicians

Practice addresses (Care Compare)

1800 E Van Buren St
Phoenix St Luke'S
Phoenix, AZ 85006-3742
Phone (602) 251-8100

6200 N la Cholla Blvd
Tucson, AZ 85741-3529
Phone (520) 229-2657

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
63.31 of 100Reported as group
Quality
74.88
Improvement activities
0
Cost
73.76

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Greater Anesthesia Solutions Nurse Anesthetist, Certified Registered CurrentSince Jan 1, 2019 Accepting new patients
Wabash Valley Anesthesia Nurse Anesthetist, Certified Registered Past Accepting new patients
Alta Anesthesia Associates of Georgia, PC Nurse Anesthetist, Certified Registered PastSince Nov 11, 2012 Accepting new patients
Regional Anesthesia Group Inc Nurse Anesthetist, Certified Registered Past Accepting new patients
Medical Anesthesia and Pain Management Consultants, P.a. Past Accepting new patients
Wolverine Anesthesia Consultants, Inc. Nurse Anesthetist, Certified Registered Past Accepting new patients
Anesthesia Associates of the Palm Beaches PA Nurse Anesthetist, Certified Registered Past Accepting new patients
US Anesthesia Partners of Florida Inc. Nurse Anesthetist, Certified Registered Past Accepting new patients

Locations

5656 S Power Rd
Gilbert, AZ 85295
Phone (480) 840-3733

18701 N 67th Ave
Glendale, AZ 85308
Phone (623) 561-1000

5880 S Hospital Dr
Globe, AZ 85501
Phone (928) 402-1217

1301 S Crismon Rd
#C
Mesa, AZ 85209

1301 S Crismon Rd
Mesa, AZ 85209
Phone (480) 358-6300

1800 E Van Buren St
Phoenix, AZ 85006
Phone (602) 251-8100

36453 N Gantzel Rd
Ste 102
San Tan Vly, AZ 85140
Phone (480) 562-5292

Organizations & group practices 9

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 4

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": "1153008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714003200000",
    "number": "1063439834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21215 E VALLEJO ST",
            "city": "QUEEN CREEK",
            "state": "AZ",
            "postal_code": "851425332",
            "telephone_number": "407-864-0420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 S CRISMON RD",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852093767",
            "telephone_number": "800-402-0881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEPAOLO",
        "first_name": "JUANCHO",
        "middle_name": "C.",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-16",
        "last_updated": "2024-04-25",
        "certification_date": "2024-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "AZ",
            "license": "CRNA0791",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3038203 00",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "G2859",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "G2859P",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2024; 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.