Individual provider Active NPI

Jal A Atkielski

  • Certified Registered Nurse Anesthetist
  • Tucson, AZ
National Provider Identifier
1407319478
Registry record updated Dec 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
231877 Issued in AZ
Practice address
11045 E Linden St
Tucson, AZ 85749-9774
Phone
(520) 360-7250
NPI assigned
Apr 8, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN160719 AZ
Certified Registered Nurse Anesthetist 367500000X 231877 AZ Primary

Addresses

Primary practice location

11045 E Linden St
Tucson, AZ 85749-9774

Mailing address

11045 E Linden St
Tucson, AZ 85749-9774
Phone (520) 360-7250

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191023001820 AZ Practitioner - Certified Registered Nurse Anesthetist (Crna) 5991037053 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ias Arizona PLLCGroup PAC ID 7517312648, 122 clinicians

Practice addresses (Care Compare)

5301 E Grant Rd
Tucson, AZ 85712-2805
Phone (469) 340-1366

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as group
Quality
0
Improvement activities
0

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
231877AZMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Tucson Ambulatory Anesthesia LLC Nurse Anesthetist, Certified Registered CurrentSince Jun 18, 2023 Accepting new patients
Ias Arizona PLLC CurrentSince Sep 20, 2023 Accepting new patients
Anesthesia Associates of Tucson LLC CurrentSince Apr 8, 2024 Accepting new patients

Locations

5240 E Knight Dr
Ste 104
Tucson, AZ 85712
Phone (520) 795-4202

2424 N Wyatt Dr
Ste 160
Tucson, AZ 85712
Phone (520) 784-6500

5301 E Grant Rd
Tucson, AZ 85712
Phone (520) 324-1344

7445 E Tanque Verde Rd
Tucson, AZ 85715
Phone (520) 722-0744

10360 E Drexel Rd
Tucson, AZ 85747
Phone (469) 340-1366

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1554681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638921600000",
    "number": "1407319478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11045 E LINDEN ST",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857499774",
            "telephone_number": "520-360-7250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11045 E LINDEN ST",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857499774",
            "telephone_number": "520-360-7250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ATKIELSKI",
        "first_name": "JAL",
        "middle_name": "A",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-08",
        "last_updated": "2021-12-08",
        "certification_date": "2021-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "AZ",
            "license": "RN160719",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "AZ",
            "license": "231877",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2021; 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.