Organization Active NPI

Prime Anesthesia Consultants, LLC

  • Pain Medicine (Anesthesiology) Physician
  • Mesa, AZ
National Provider Identifier
1306496336
Registry record updated Jun 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
Legal business name
PRIME ANESTHESIA CONSULTANTS, LLC
Practice address
1810 S Crismon Rd Ste 188
Mesa, AZ 85209-3900
Phone
(480) 900-7373
Fax
(480) 900-6844
NPI assigned
Sep 11, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2020

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

Authorized official

Name
Zeeshan Malik, DONPI 1427491174
Title
Physician Owner
Phone
(702) 374-2910

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Anesthesiology) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207LP2900X Primary

Addresses

Primary practice location

1810 S Crismon Rd Ste 188
Mesa, AZ 85209-3900

Mailing address

1810 S Crismon Rd Ste 188
Mesa, AZ 85209-3900
Phone (480) 900-7373

Other practice location 1

1641 E Osborn Rd Ste 6
Phoenix, AZ 85016-7146
Phone (480) 900-7373

Other practice location 2

535 E McKellips Rd Ste 121
Mesa, AZ 85203-2527
Phone (480) 900-7373

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200714000390 AZ Part B Supplier - Clinic/Group Practice 3274956917 Receives reassigned benefits from 3 practitioners
Practice locations: Mesa, AZ; Phoenix, AZ

National Provider Directory

National Provider Directory

Locations

535 E McKellips Rd
Ste 121
Mesa, AZ 85203
Phone (480) 685-1027

1810 S Crismon Rd
Ste 188
Mesa, AZ 85209
Phone (480) 900-7373

10603 N Hayden Rd
Ste 100
Scottsdale, AZ 85260

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1568160000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1592524800000",
    "number": "1306496336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1810 S CRISMON RD STE 188",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852093900",
            "telephone_number": "480-900-7373",
            "fax_number": "480-900-6844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1810 S CRISMON RD STE 188",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852093900",
            "telephone_number": "480-900-7373",
            "fax_number": "480-900-6844"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1641 E Osborn Rd Ste 6",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850167146",
            "country_code": "US",
            "telephone_number": "480-900-7373",
            "fax_number": "480-900-6844",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "535 E McKellips Rd Ste 121",
            "address_purpose": "LOCATION",
            "city": "Mesa",
            "state": "AZ",
            "postal_code": "852032527",
            "country_code": "US",
            "telephone_number": "480-900-7373",
            "fax_number": "480-900-6844",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PRIME ANESTHESIA CONSULTANTS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-09-11",
        "last_updated": "2020-06-19",
        "certification_date": "2020-06-19",
        "status": "A",
        "authorized_official_last_name": "MALIK",
        "authorized_official_first_name": "ZEESHAN",
        "authorized_official_title_or_position": "PHYSICIAN OWNER",
        "authorized_official_telephone_number": "702-374-2910",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2020; 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.