Organization Active NPI

North Gate Anesthesia PC

  • Certified Registered Nurse Anesthetist
  • Casa Grande, AZ
National Provider Identifier
1073026464
Registry record updated Feb 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
CRNA1208 Issued in AZ
Legal business name
NORTH GATE ANESTHESIA PC
Practice address
1780 E Florence Blvd Ste 104
Casa Grande, AZ 85122-4782
Phone
(480) 323-5131
NPI assigned
Nov 8, 2017
Last updated
Feb 14, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2023

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

Authorized official

Name
Brian Marler, CRNANPI 1275996712
Title
President
Phone
(480) 323-5131

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered NurseGroup: 193200000X MULTI-SPECIALTY GROUP 163W00000X RN-83704 NM
Certified Registered Nurse AnesthetistGroup: 193200000X MULTI-SPECIALTY GROUP 367500000X CRNA1208 AZ Primary

Addresses

Primary practice location

1780 E Florence Blvd Ste 104
Casa Grande, AZ 85122-4782

Mailing address

3527 E Mallory Cir
Mesa, AZ 85213-1744
Phone (480) 323-5131

Other identifiers 1

IdentifierTypeStateIssuer
CRNA01424OtherNMCRNA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20171213001910 AZ Part B Supplier - Clinic/Group Practice 5294093654 Receives reassigned benefits from 3 practitioners
Practice locations: Casa Grande, AZ

National Provider Directory

National Provider Directory

Locations

1780 E Florence Blvd
Ste 104
Casa Grande, AZ 85122
Phone (520) 426-1928

Practitioners & affiliated clinicians

Practitioners 3

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": "1510099200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1676332800000",
    "number": "1073026464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3527 E MALLORY CIR",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852131744",
            "telephone_number": "480-323-5131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1780 E FLORENCE BLVD STE 104",
            "city": "CASA GRANDE",
            "state": "AZ",
            "postal_code": "851224782",
            "telephone_number": "480-323-5131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH GATE ANESTHESIA PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-08",
        "last_updated": "2023-02-14",
        "certification_date": "2023-02-09",
        "status": "A",
        "authorized_official_last_name": "MARLER",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "480-323-5131",
        "authorized_official_credential": "CRNA"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse",
            "state": "NM",
            "license": "RN-83704",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "AZ",
            "license": "CRNA1208",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CRNA",
            "identifier": "CRNA01424",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Casa Grande, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2023; 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.