Individual provider Active NPI

Douglas G Bufkin, CRNA

  • Certified Registered Nurse Anesthetist
  • Phoenix, AZ
National Provider Identifier
1104132356
Registry record updated Feb 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
299836 Issued in AZ
Practice address
4605 E Elwood St Ste 500
Phoenix, AZ 85040-1978
Phone
(602) 200-9021
NPI assigned
Aug 26, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 201260043CRNA OR
Certified Registered Nurse Anesthetist 367500000X 299836 AZ Primary

Addresses

Primary practice location

4605 E Elwood St Ste 500
Phoenix, AZ 85040-1978

Mailing address

3181 SW Sam Jackson Park Rd
Portland, OR 97239-3011
Phone (503) 494-7641

Other practice location 1

111 S 11th St
Suite 8490
Philadelphia, PA 19107-4824
Phone (215) 955-6161

Other practice location 2

3181 SW Sam Jackson Park Rd
Portland, OR 97239-3011
Phone (503) 494-7641

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR, AZ2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20130219000096 OR Practitioner - Certified Registered Nurse Anesthetist (Crna) 4880881341 Reassigns benefits to 1 organization
I20240215004423 AZ Practitioner - Certified Registered Nurse Anesthetist (Crna) 4880881341 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Banner Hospital Based Physicians Arizona LLC 636 clinicians

Practice addresses (Care Compare)

1400 S Dobson Rd
Mesa, AZ 85202-4707
Phone (480) 412-3000

Hospital & facility affiliations

  • Banner Desert Medical Center Hospital, Mesa, AZ, CCN 030065

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
98.65
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
299836AZMDCertified Registered Nurse Anesthetist
201260043CRNAORMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Banner Hospital Based Physicians Arizona LLC CurrentSince Aug 1, 2025 Accepting new patients
Banner Hospital Based Physicians Arizona LLC Current Accepting new patients
Anesthesia Associates Northwest LLC CurrentSince Dec 1, 2015 Accepting new patients
Banner Hospital Based Physicians Arizona LLC CurrentSince Aug 1, 2025 Accepting new patients
Anesthesia Partners of Arizona LLC CurrentSince Feb 1, 2024 Accepting new patients

Locations

1405 S Alma School Rd
Chandler, AZ 85286
Phone (480) 256-7000

1400 S Dobson Rd
Mesa, AZ 85202
Phone (480) 412-3000

4605 E Elwood St
Ste 500
Phoenix, AZ 85040
Phone (469) 998-7443

1111 E McDowell Rd
Phoenix, AZ 85006
Phone (602) 239-2000

120 NW 14th Ave
Ste 200
Portland, OR 97209
Phone (503) 771-1883

2221 Lakeside Blvd
Ste 600
Richardson, TX 75082
Phone (469) 998-7450

Organizations & group practices 5

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 1

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": "1282780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707350400000",
    "number": "1104132356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3181 SW SAM JACKSON PARK RD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972393011",
            "telephone_number": "503-494-7641",
            "fax_number": "503-494-8368"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4605 E ELWOOD ST STE 500",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850401978",
            "telephone_number": "602-200-9021"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "111 S 11th St",
            "address_2": "Suite 8490",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191074824",
            "country_code": "US",
            "telephone_number": "215-955-6161",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3181 SW Sam Jackson Park Rd",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972393011",
            "country_code": "US",
            "telephone_number": "503-494-7641",
            "fax_number": "503-494-8368",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BUFKIN",
        "first_name": "DOUGLAS",
        "middle_name": "G",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-08-26",
        "last_updated": "2024-02-08",
        "certification_date": "2024-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "OR",
            "license": "201260043CRNA",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "AZ",
            "license": "299836",
            "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 Feb 8, 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.