Individual provider Active NPI

Luke Anderson

  • Anesthesiology Physician
  • Phoenix, AZ
National Provider Identifier
1720549074
Registry record updated Jul 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
009881 Issued in AZ
Practice address
350 W Thomas Rd
Phoenix, AZ 85013-4409
Phone
(602) 343-7976
NPI assigned
Mar 28, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 4, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 009881 AZ Primary

Addresses

Primary practice location

350 W Thomas Rd
Phoenix, AZ 85013-4409

Mailing address

350 W Thomas Rd
Phoenix, AZ 85013-4409
Phone (602) 343-7976

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231030001666 AZ Practitioner - Anesthesiology 1850747767 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
State University of New York Downstate Medical Center, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pca AnesthesiaGroup PAC ID 1658675558, 54 clinicians

Practice addresses (Care Compare)

300 W Clarendon Ave
Suite 142
Phoenix, AZ 85013-3449
Phone (602) 234-1803

Hospital & facility affiliations

  • St Josephs Hospital and Medical Center Hospital, Phoenix, AZ, CCN 030024

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
009881AZMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Pca Anesthesia Anesthesiology CurrentSince Sep 5, 2023 Accepting new patients
Katalin H Boleratzky MD Inc Anesthesiology Past Accepting new patients

Locations

300 W Clarendon Ave
Ste 142
Phoenix, AZ 85013
Phone (602) 234-1803

350 W Thomas Rd
Phoenix, AZ 85013
Phone (480) 339-5001

2421 E Southern Ave
Ste 7
Tempe, AZ 85282
Phone (480) 832-3600

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.

Hospital & facility affiliations 4

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": "1553731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720051200000",
    "number": "1720549074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 W THOMAS RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850134409",
            "telephone_number": "602-343-7976"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 W THOMAS RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850134409",
            "telephone_number": "602-343-7976"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "LUKE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-28",
        "last_updated": "2024-07-04",
        "certification_date": "2024-07-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "AZ",
            "license": "009881",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.