Individual provider Active NPI

Paul T Sutera, M.D.

  • Pain Medicine (Anesthesiology) Physician
  • Mohave Valley, AZ
National Provider Identifier
1740270750
Registry record updated May 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
License
21975 Issued in AZ
Practice address
10225 S Harbor Ave Ste 5
Mohave Valley, AZ 86440-9699
Phone
(928) 361-9991
Fax
(287) 046-0679
NPI assigned
Oct 21, 2005
Last updated
May 29, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 29, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Anesthesiology) Physician 207LP2900X 21975 AZ Primary

Addresses

Primary practice location

10225 S Harbor Ave Ste 5
Mohave Valley, AZ 86440-9699

Mailing address

2917 Camino del Rio
Bullhead City, AZ 86442-7824
Phone (928) 542-9103

Other identifiers 1

IdentifierTypeStateIssuer
145773 001MedicaidAZ

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
I20120125000259 AZ Practitioner - AnesthesiologyPractitioner - Pain Management 5890771380 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
AnesthesiologyAlso: Pain Management
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2767 Silver Creek Rd
Suite a
Bullhead City, AZ 86442-8227
Phone (928) 542-9103

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Western Az Anesthesia & Pain Management PC Pain Medicine CurrentSince Feb 6, 2023 Accepting new patients

Locations

2767 Silver Creek Rd
Ste A
Bullhead City, AZ 86442
Phone (928) 542-9103

1510 E Wagon Wheel Ln
Ste 110
Fort Mohave, AZ 86426
Phone (904) 994-5560

5300 S Highway 95
Ste I
Fort Mohave, AZ 86426
Phone (928) 768-8285

10225 S Harbor Ave
Mohave Valley, AZ 86440

10225 S Harbor Ave
Ste 5
Mohave Valley, AZ 86440
Phone (928) 361-9991

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1129852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716940800000",
    "number": "1740270750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2917 CAMINO DEL RIO",
            "city": "BULLHEAD CITY",
            "state": "AZ",
            "postal_code": "864427824",
            "telephone_number": "928-542-9103",
            "fax_number": "928-704-6067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10225 S HARBOR AVE STE 5",
            "city": "MOHAVE VALLEY",
            "state": "AZ",
            "postal_code": "864409699",
            "telephone_number": "928-361-9991",
            "fax_number": "287-046-0679"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUTERA",
        "first_name": "PAUL",
        "middle_name": "T",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-21",
        "last_updated": "2024-05-29",
        "certification_date": "2024-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "AZ",
            "license": "21975",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "145773 001",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mohave Valley, AZ

Sources for this page

Verify at the official NPI Registry.