Active NPI
Anthony Wanjohi Nderitu, CRNA
- Certified Registered Nurse Anesthetist
- Phoenix, AZ
National Provider Identifier
1629366802
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- CRNA1078
- Practice address
- 1850 N Central Ave
Suite 1600
Phoenix, AZ 85004-4527 - Phone
- (602) 262-8900
- NPI assigned
- Jul 21, 2011
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | 2004022872 | MO | |
| Certified Registered Nurse Anesthetist | 367500000X | CRNA1078 | AZ | Primary |
Addresses
Primary practice location
1850 N Central Ave
Suite 1600
Phoenix, AZ 85004-4527
Mailing address
13629 W Evans Dr
Surprise, AZ 85379-8349
Phone (417) 396-0013
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AZ
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- Other, 2011
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
5555 W Thunderbird Rd
Glendale, AZ 85306-4622
Phone (602) 865-5555
Hospital & facility affiliations
- Banner Estrella Medical Center
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CRNA1078 | AZ | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| East Valley Endoscopy LLC | Past | Accepting new patients |
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.
-
- Anesthesiology Physician
- Phoenix, AZ
- NPI 1285660704
-
- Ambulatory Surgical Clinic/Center
- Mesa, AZ
- NPI 1164414447
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Phoenix, AZ
- NPI 1275566200
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1311206400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1610409600000",
"number": "1629366802",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13629 W EVANS DR",
"city": "SURPRISE",
"state": "AZ",
"postal_code": "853798349",
"telephone_number": "417-396-0013",
"fax_number": "602-262-8890"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1850 N CENTRAL AVE",
"address_2": "SUITE 1600",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850044527",
"telephone_number": "602-262-8900"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NDERITU",
"first_name": "ANTHONY",
"middle_name": "WANJOHI",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-07-21",
"last_updated": "2021-01-12",
"certification_date": "2021-01-12",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "MO",
"license": "2004022872",
"primary": false
},
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "AZ",
"license": "CRNA1078",
"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 12, 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.