Douglas Pruitt, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

28155497A Issued in IN

Practice address

6200 N la Cholla Blvd
Tucson, AZ 85741-3529

Phone

(520) 742-9000

NPI assigned

May 12, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MI, IN, OH, AZ4 enrollments

Enrollment records 4

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Saint Joseph Regional Medical Center-South Bend Campus IncGroup PAC ID 3476451790, 65 clinicians

Cep America - Anesthesia PCGroup PAC ID 3678897915, 849 clinicians

Northwest HBP Medical Services LLCGroup PAC ID 8921356536, 278 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Saint Joseph Regional Medical Center Hospital, Mishawaka, IN, CCN 150012
• Northwest Medical Center Hospital, Tucson, AZ, CCN 030085

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

Practice roles

Locations (25 of 32)

Interoperability endpoints

• Direct secure messaging: dpruitt3282997@direct.trinity-health.org

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.

• Northwest HBP Medical Services LLC

  • Emergency Medicine Physician
  • Tucson, AZ
  • NPI 1407353006
  Medicare reassignment Care Compare group NPD
• Cep America - Anesthesia PC

  • Anesthesiology Physician
  • Mishawaka, IN
  • NPI 1306722418
  Medicare reassignment Care Compare group NPD
• Saint Joseph Regional Medical Center-South Bend Campus, Inc

  • Mobile Mammography Clinic/Center
  • South Bend, IN
  • NPI 1023844693
  Medicare reassignment Care Compare group NPD
• Aas Indiana LLC

  • Anesthesiology Physician
  • Novi, MI
  • NPI 1831827021

  IN, Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Ams Northern Indiana LLC

  • Anesthesiology Physician
  • Pensacola, FL
  • NPI 1427619840

  IN, Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Associated Anesthesiologists of Fort Wayne PC

  • Anesthesiology Physician
  • Fort Wayne, IN
  • NPI 1538159140

  Nurse Anesthetist, Certified Registered, OH

  Medicare reassignment NPD
• Beacon Medical Group, Inc.

  • Family Medicine Physician
  • Mishawaka, IN
  • NPI 1033161617
  Medicare reassignment NPD
• Community Health Center of Branch County

  • General Practice Physician
  • Coldwater, MI
  • NPI 1124055009
  Medicare reassignment NPD
• Iceland Anesthesia Management, LLC

  • Anesthesiology Physician
  • Terre Haute, IN
  • NPI 1912578667

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• McLaren Thumb Region

  • Critical Access Hospital
  • Bad Axe, MI
  • NPI 1518991744
  Medicare reassignment NPD
• West Michigan Aas LLC

  • Anesthesiology Physician
  • Novi, MI
  • NPI 1295149227
  Medicare reassignment NPD
• Allied Physicians Surgery Center, LLC

  • Anesthesiology Physician
  • South Bend, IN
  • NPI 1669032942
  Medicare reassignment

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Northwest Hospital LLC

  • General Acute Care Hospital
  • Tucson, AZ
  • NPI 1487607784
  Care Compare affiliation
• Saint Joseph Regional Medical Center-South Bend Campus, Inc.

  • General Acute Care Hospital
  • Mishawaka, IN
  • NPI 1023965795
  Care Compare affiliation
• Saint Joseph Regional Medical Center-South Bend Campus, Inc.

  • General Acute Care Hospital
  • Mishawaka, IN
  • NPI 1841245594
  Care Compare affiliation

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

{
    "created_epoch": "1147392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759881600000",
    "number": "1366493579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3245 HEALTH DR STE 100",
            "city": "GRANGER",
            "state": "IN",
            "postal_code": "465301380",
            "telephone_number": "574-647-2129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6200 N LA CHOLLA BLVD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857413529",
            "telephone_number": "520-742-9000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "600 East Blvd",
            "address_purpose": "LOCATION",
            "city": "Elkhart",
            "state": "IN",
            "postal_code": "465142483",
            "country_code": "US",
            "telephone_number": "574-524-8130",
            "fax_number": "574-524-8138",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PRUITT",
        "first_name": "DOUGLAS",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-12",
        "last_updated": "2025-10-08",
        "certification_date": "2025-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IN",
            "license": "28162626",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IN",
            "license": "28155497A",
            "primary": true
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "AZ",
            "license": "326345",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200047710",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Caitlin Provencio, RD
• Providence Services Corporation
• Jennifer Providence, LAC
• Providers Direct, PLLC
• Maria A Proytcheva, M.D.
• Melissa Pruitt, FNP-C
• Ashley Prunty, OTR/L
• Nancy B. Prunty, N.P.
• Randall S. Prust, M.D.
• Steven Michael Luzader Prust, M.D.

• 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 Oct 8, 2025; 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.