Individual provider Active NPI

Aaron Petrillo, M.D.

  • Anesthesiology Physician
  • Phoenix, AZ
National Provider Identifier
1174972764
Registry record updated Jun 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
60864 Issued in AZ
Practice address
645 E Missouri Ave
Ste 300
Phoenix, AZ 85012-1351
Phone
(602) 262-8917
Fax
(602) 262-8890
NPI assigned
Jun 6, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 60864 AZ Primary

Addresses

Primary practice location

645 E Missouri Ave
Ste 300
Phoenix, AZ 85012-1351

Mailing address

645 E Missouri Ave
Ste 300
Phoenix, AZ 85012-1351
Phone (602) 262-8917

Other identifiers 1

IdentifierTypeStateIssuer
007299MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200609001527 AZ Practitioner - Anesthesiology 9133414220 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
University of Oklahoma College of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Valley Anesthesiology Consultants IncGroup PAC ID 4880591841, 284 clinicians

Practice addresses (Care Compare)

1500 S Dobson Rd
Suite 101
Mesa, AZ 85202-4722
Phone (480) 412-3577

19829 N 27TH Ave
Phoenix, AZ 85027-4001
Phone (623) 879-6100

250 E Dunlap Ave
Phoenix, AZ 85020-2825
Phone (602) 943-2381

33400 N 32ND Ave
Phoenix, AZ 85085-8876
Phone (623) 683-5000

9003 E Shea Blvd
Scottsdale, AZ 85260-6709
Phone (480) 323-3000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
60864AZMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Valley Anesthesiology Consultants, Inc. Anesthesiology CurrentSince Jul 1, 2020 Accepting new patients

Locations

1500 S Dobson Rd
Ste 101
Mesa, AZ 85202
Phone (480) 306-6098

645 E Missouri Ave
Ste 300
Phoenix, AZ 85012
Phone (602) 262-8917

19829 N 27th Ave
Phoenix, AZ 85027
Phone (602) 879-5720

1850 N Central Ave
Ste 1600
Phoenix, AZ 85004
Phone (602) 744-4760

Organizations & group practices 1

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": "1465171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623628800000",
    "number": "1174972764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "645 E MISSOURI AVE",
            "address_2": "STE 300",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850121351",
            "telephone_number": "602-262-8917",
            "fax_number": "602-262-8890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "645 E MISSOURI AVE",
            "address_2": "STE 300",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850121351",
            "telephone_number": "602-262-8917",
            "fax_number": "602-262-8890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETRILLO",
        "first_name": "AARON",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-06",
        "last_updated": "2021-06-14",
        "certification_date": "2021-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "AZ",
            "license": "60864",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "007299",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.