Jeremiah James Palicka, RN, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

0024187576 Issued in VA

Practice address

1625 N Campbell Ave
Tucson, AZ 85719-4330

Phone

(520) 694-0111

NPI assigned

Aug 18, 2020

Last updated

Dec 9, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in DC

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Registered Nurse

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Northstar Anesthesia of Virginia, LLC

  • Anesthesiology Physician
  • Alexandria, VA
  • NPI 1194488791

  DC

  Medicare reassignment NPD

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

{
    "created_epoch": "1597708800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733702400000",
    "number": "1184236531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6968 W TACNA DR",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857431422",
            "telephone_number": "520-603-2259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1625 N CAMPBELL AVE",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857194330",
            "telephone_number": "520-694-0111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALICKA",
        "first_name": "JEREMIAH",
        "middle_name": "JAMES",
        "credential": "RN, CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-08-18",
        "last_updated": "2024-12-09",
        "certification_date": "2024-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "VA",
            "license": "0024187576",
            "primary": true
        },
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "AZ",
            "license": "RN210075",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rita Rebecca Palanjian, MD
• Cheryl Ann Palen, B.S., M.ED.
• Megan Palen
• Leanna Palermo, D.C.
• Ian Palese, PHARMD
• Brigitte Pallavicini
• Frank Paul Pallavicini II, LPC
• Palm View Assisted Living, LLC. (Palm View)
• Adriona Palmer
• Andrew Thomas Palmer, RN

• Certified Registered Nurse Anesthetist in Tucson, AZ
• Providers in Tucson, AZ by specialty
• Certified Registered Nurse Anesthetist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2024; 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.