Individual provider Active NPI

Justin B McBride, CRNA

  • Certified Registered Nurse Anesthetist
  • Phoenix, AZ
National Provider Identifier
1619992476
Registry record updated Jan 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
RN117466 Issued in AZ
Practice address
1800 E Van Buren St
Phoenix, AZ 85006-3742
Phone
(602) 251-8100
NPI assigned
Jul 13, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 19, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X RN117466 AZ Primary

Addresses

Primary practice location

1800 E Van Buren St
Phoenix, AZ 85006-3742

Mailing address

20489 E Pecan LN
Queen Creek, AZ 85142-5092
Phone (480) 214-3012

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070111000640 AZ Practitioner - Certified Registered Nurse Anesthetist (Crna) 8921024407 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
63.31 of 100Reported as group
Quality
74.88
Improvement activities
0
Cost
73.76

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN117466AZMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Greater Anesthesia Solutions Nurse Anesthetist, Certified Registered CurrentSince May 23, 2014 Accepting new patients
Cumberland Anesthesia Associates, Inc. Nurse Anesthetist, Certified Registered Past Accepting new patients

Locations

4545 N Hunt Hwy
Florence, AZ 85132
Phone (480) 258-6100

5656 S Power Rd
Gilbert, AZ 85295
Phone (480) 840-3733

1301 S Crismon Rd
Mesa, AZ 85209
Phone (480) 358-6300

1301 S Crismon Rd
#C
Mesa, AZ 85209

1800 E Van Buren St
Phoenix, AZ 85006
Phone (602) 251-8100

Organizations & group practices 2

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": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1326931200000",
    "number": "1619992476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20489 E PECAN LN",
            "city": "QUEEN CREEK",
            "state": "AZ",
            "postal_code": "851425092",
            "telephone_number": "480-214-3012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 E VAN BUREN ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850063742",
            "telephone_number": "602-251-8100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCBRIDE",
        "first_name": "JUSTIN",
        "middle_name": "B",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-13",
        "last_updated": "2012-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "AZ",
            "license": "RN117466",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2012; 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.