Individual provider Active NPI

Simonette Yuson Pagkos

  • Certified Registered Nurse Anesthetist
  • Scottsdale, AZ
National Provider Identifier
1306247192
Registry record updated Oct 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
CRNA1127 Issued in AZ
Practice address
13400 E Shea Blvd
Scottsdale, AZ 85259-5452
Phone
(480) 301-8000
NPI assigned
Sep 11, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine Registered Nurse 163WC0200X 666851-1 NY
Certified Registered Nurse Anesthetist 367500000X 666851-1 NY
Certified Registered Nurse Anesthetist 367500000X CRNA1127 AZ Primary

Addresses

Primary practice location

13400 E Shea Blvd
Scottsdale, AZ 85259-5452

Mailing address

13400 E Shea Blvd
Scottsdale, AZ 85259-5452
Phone (480) 301-8000

Other practice location 1

8901 E Raintree Dr Ste 100
Scottsdale, AZ 85260-7026
Phone (480) 767-2100

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address spagkos395337@ehrdirect.mayoclinicmsg.org

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150908003096 AZ Practitioner - Certified Registered Nurse Anesthetist (Crna) 8325269764 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mayo Clinic ArizonaGroup PAC ID 7012829930, 1,618 clinicians

Practice addresses (Care Compare)

13400 E Shea Blvd
Scottsdale, AZ 85259-5404
Phone (480) 301-8000

Hospital & facility affiliations

  • Mayo Clinic Hospital Hospital, Phoenix, AZ, CCN 030103

Merit-based Incentive Payment System (MIPS)

Final score
86.47 of 100Reported as group
Quality
78.27
Promoting interoperability
100
Improvement activities
40
Cost
76.62

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
666851-1NYMDCritical Care Medicine Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Banner - University Hospital Based Physicians LLC CurrentSince May 1, 2026 Accepting new patients
Mesa Anesthesia Services PLLC Nurse Anesthetist, Certified Registered CurrentSince May 1, 2018 Accepting new patients
Banner - University Hospital Based Physicians LLC CurrentSince May 1, 2026 Accepting new patients
Valley Anesthesiology Consultants, Inc. CurrentSince Aug 11, 2015 Accepting new patients
Integrated Anesthesia Consultants PLC CurrentSince Jan 1, 2017 Accepting new patients
Scottsdale Surgical Partners LLC CurrentSince Oct 1, 2018 Accepting new patients

Locations

3615 S Rome St
Gilbert, AZ 85297
Phone (480) 245-4425

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

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

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

8573 E Princess Dr
Ste 215
Scottsdale, AZ 85255
Phone (480) 563-5757

8901 E Raintree Dr
Ste 100
Scottsdale, AZ 85260
Phone (480) 676-2100

Organizations & group practices 7

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": "1410393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601596800000",
    "number": "1306247192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13400 E SHEA BLVD",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852595452",
            "telephone_number": "480-301-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13400 E SHEA BLVD",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852595452",
            "telephone_number": "480-301-8000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8901 E Raintree Dr Ste 100",
            "address_purpose": "LOCATION",
            "city": "Scottsdale",
            "state": "AZ",
            "postal_code": "852607026",
            "country_code": "US",
            "telephone_number": "480-767-2100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PAGKOS",
        "first_name": "SIMONETTE",
        "middle_name": "YUSON",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-11",
        "last_updated": "2020-10-02",
        "certification_date": "2020-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "NY",
            "license": "666851-1",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NY",
            "license": "666851-1",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "AZ",
            "license": "CRNA1127",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "spagkos395337@ehrdirect.mayoclinicmsg.org",
            "affiliation": "N",
            "address_1": "13400 E Shea Blvd",
            "city": "Scottsdale",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "852595452",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Scottsdale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2020; 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.