Individual provider Active NPI

Jill Ann Sulak, CRNA

  • Certified Registered Nurse Anesthetist
  • Tucson, AZ
National Provider Identifier
1508092719
Registry record updated Jul 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
316660 Issued in AZ
Practice address
1501 N Campbell Ave
Tucson, AZ 85724-3206
Phone
(520) 694-0111
NPI assigned
Jun 2, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X C-APN.0000425-C-CRNA CO
Certified Registered Nurse Anesthetist 367500000X 768178 TX
Certified Registered Nurse Anesthetist 367500000X 9529 CT
Certified Registered Nurse Anesthetist 367500000X 316660 AZ Primary

Addresses

Primary practice location

1501 N Campbell Ave
Tucson, AZ 85724-3206

Mailing address

12320 Pine Oak Dr
Dickinson, TX 77539-8234
Phone (512) 777-9368

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO, AZ2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20160718002439 CO Practitioner - Certified Registered Nurse Anesthetist (Crna) 3173676202 Reassigns benefits to 2 organizations
I20241213001912 AZ Practitioner - Certified Registered Nurse Anesthetist (Crna) 3173676202 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Banner-University Medical GroupGroup PAC ID 7719899871, 1,066 clinicians

Practice addresses (Care Compare)

1625 N Campbell Ave
Tucson, AZ 85719-4330
Phone (520) 694-0111

Hospital & facility affiliations

  • Banner - University Medical Center Tucson Campus Hospital, Tucson, AZ, CCN 030064

Merit-based Incentive Payment System (MIPS)

Final score
84.8 of 100Reported as group
Quality
85
Improvement activities
40
Cost
76.83

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C-APN.0000425-C-CRNACOMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Banner-University Medical Group CurrentSince Aug 1, 2025 Accepting new patients
Banner-University Medical Group CurrentSince Aug 1, 2025 Accepting new patients
Banner-University Medical Group Current Accepting new patients
Northern Colorado Anesthesia Professionals PLLC CurrentSince Jul 11, 2016 Accepting new patients
US Anesthesia Partners of Colorado Inc. Nurse Anesthetist, Certified Registered CurrentSince Sep 23, 2021 Accepting new patients
Northwest HBP Medical Services LLC CurrentSince Nov 20, 2024 Accepting new patients

Locations

2800 E Ajo Way
Tucson, AZ 85713
Phone (520) 294-4471

6200 N La Cholla Blvd
Tucson, AZ 85741
Phone (520) 229-2657

3838 N Campbell Ave
Bldg 2
Tucson, AZ 85719

1501 N Campbell Ave
Tucson, AZ 85724
Phone (520) 626-7747

1625 N Campbell Ave
Tucson, AZ 85719

1501 S Potomac St
Denver, CO 80012
Phone (303) 695-2604

1236 E Elizabeth St
Ste 1
Fort Collins, CO 80524
Phone (970) 484-6256

3702 Automation Way
Ste 103
Fort Collins, CO 80525
Phone (970) 922-3622

8000 E Maplewood Ave
Ste 120
Greenwood Village, CO 80111

10101 Ridgegate Pkwy
Lone Tree, CO 80124
Phone (720) 225-1000

2500 Rocky Mountain Ave
Loveland, CO 80538
Phone (970) 297-6425

Organizations & group practices 6

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 2

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": "1243900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752710400000",
    "number": "1508092719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12320 PINE OAK DR",
            "city": "DICKINSON",
            "state": "TX",
            "postal_code": "775398234",
            "telephone_number": "512-777-9368"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 N CAMPBELL AVE",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857243206",
            "telephone_number": "520-694-0111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULAK",
        "first_name": "JILL",
        "middle_name": "ANN",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-02",
        "last_updated": "2025-07-17",
        "certification_date": "2025-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CO",
            "license": "C-APN.0000425-C-CRNA",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "768178",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CT",
            "license": "9529",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "AZ",
            "license": "316660",
            "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 Jul 17, 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.