Individual provider Active NPI

Kuoc Mathiang

  • Certified Registered Nurse Anesthetist
  • Phoenix, AZ
National Provider Identifier
1679294037
Registry record updated Jul 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
218491 Issued in AZ
Practice address
20425 N 7TH St Apt 3072
Phoenix, AZ 85024-6019
Phone
(480) 612-7532
NPI assigned
Sep 6, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine Registered Nurse 163WC0200X 218491 AZ
Certified Registered Nurse Anesthetist 367500000X 218491 AZ Primary

Addresses

Primary practice location

20425 N 7TH St Apt 3072
Phoenix, AZ 85024-6019

Mailing address

20425 N 7TH St Apt 3072
Phoenix, AZ 85024-6019
Phone (480) 612-7532

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250721003813 AZ Practitioner - Certified Registered Nurse Anesthetist (Crna) 8729594338 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northwest HBP Medical Services LLCGroup PAC ID 8921356536, 278 clinicians

Practice addresses (Care Compare)

1551 E Tangerine Rd
Oro Valley, AZ 85755-6213
Phone (520) 229-2657

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
218491AZMDCritical Care Medicine Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Northwest HBP Medical Services LLC CurrentSince Jul 7, 2025 Accepting new patients

Locations

1551 E Tangerine Rd
Oro Valley, AZ 85755
Phone (520) 901-3500

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

Organizations & group practices 1

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": "1662422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751846400000",
    "number": "1679294037",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20425 N 7TH ST APT 3072",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850246019",
            "telephone_number": "480-612-7532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20425 N 7TH ST APT 3072",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850246019",
            "telephone_number": "480-612-7532"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATHIANG",
        "first_name": "KUOC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-09-06",
        "last_updated": "2025-07-07",
        "certification_date": "2025-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "AZ",
            "license": "218491",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "AZ",
            "license": "218491",
            "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 Jul 7, 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.