NPIMap

Organization Active NPI

Camelback Anesthesia PLLC

  • Pain Medicine (Anesthesiology) Physician
  • Tempe, AZ
National Provider Identifier
1831560176
Registry record updated Nov 4, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
License
19985 Issued in AZ
Legal business name
CAMELBACK ANESTHESIA PLLC
Practice address
2421 E Southern Ave
Ste 1
Tempe, AZ 85282-7612
Phone
(480) 425-2160
Fax
(480) 351-8797
NPI assigned
Oct 13, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2015

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

Authorized official

Name
Dr. Gregg Martin Citron, MDNPI 1558322644
Title
Physician
Phone
(480) 425-2160

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Anesthesiology) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207LP2900X 19985 AZ Primary

Addresses

Primary practice location

2421 E Southern Ave
Ste 1
Tempe, AZ 85282-7612

Mailing address

2421 E Southern Ave
Ste 1
Tempe, AZ 85282-7612
Phone (480) 425-2160

Other names 1

  • Camelback Pain Consultants Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20151211001207 AZ Part B Supplier - Clinic/Group Practice 0143205419 Receives reassigned benefits from 63 practitioners
Practice locations: Tempe, AZ

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 68

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 68

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1444694400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1446595200000",
    "number": "1831560176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2421 E SOUTHERN AVE",
            "address_2": "STE 1",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852827612",
            "telephone_number": "480-425-2160",
            "fax_number": "480-351-8797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2421 E SOUTHERN AVE",
            "address_2": "STE 1",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852827612",
            "telephone_number": "480-425-2160",
            "fax_number": "480-351-8797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAMELBACK ANESTHESIA PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-13",
        "last_updated": "2015-11-04",
        "status": "A",
        "authorized_official_last_name": "CITRON",
        "authorized_official_first_name": "GREGG",
        "authorized_official_middle_name": "MARTIN",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "480-425-2160",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "AZ",
            "license": "19985",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Camelback Pain Consultants",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tempe, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.