Active NPI
Anita L Desilva, CRNA
- Certified Registered Nurse Anesthetist
- Phoenix, AZ
National Provider Identifier
1740264449
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 0204
- Practice address
- 5777 E Mayo Blvd
Phoenix, AZ 85054-4502 - Phone
- (480) 301-8000
- NPI assigned
- Dec 6, 2005
- Last updated
- Apr 13, 2018
- Sex
- Female
- 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 | RN074439 | AZ | |
| Certified Registered Nurse Anesthetist | 367500000X | 0204 | AZ | Primary |
Addresses
Primary practice location
5777 E Mayo Blvd
Phoenix, AZ 85054-4502
Mailing address
5777 E Mayo Blvd
Phoenix, AZ 85054-4502
Phone (480) 301-8000
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 719362 | Medicaid | AZ | |
| 430076548 | Other | AZ | RAILROAD MEDICARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0204 | AZ | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Squaw Peak Anesthesia Inc | Past | Accepting new patients | |
| Squaw Peak Anesthesia Inc | Nurse Anesthetist, Certified Registered | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Registered Nurse
- Tempe, AZ
- NPI 1134352925
-
- Certified Registered Nurse Anesthetist
- Sun City, AZ
- NPI 1548359128
Nurse Anesthetist, Certified Registered
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1133827200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1523577600000",
"number": "1740264449",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5777 E MAYO BLVD",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850544502",
"telephone_number": "480-301-8000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5777 E MAYO BLVD",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850544502",
"telephone_number": "480-301-8000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DESILVA",
"first_name": "ANITA",
"middle_name": "L",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-12-06",
"last_updated": "2018-04-13",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "AZ",
"license": "RN074439",
"primary": false
},
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "AZ",
"license": "0204",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "719362",
"state": "AZ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "430076548",
"state": "AZ"
}
],
"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 Apr 13, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.