Individual provider Active NPI

Brad Michael Peterson, CRNA

  • Certified Registered Nurse Anesthetist
  • Gilbert, AZ
National Provider Identifier
1851644405
Registry record updated Dec 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
CRNA0889 Issued in AZ
Practice address
4001 E Baseline Rd Ste 102
Gilbert, AZ 85234-2736
Phone
(480) 565-8045
NPI assigned
Oct 19, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 11, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X CRNA0889 AZ Primary

Addresses

Primary practice location

4001 E Baseline Rd Ste 102
Gilbert, AZ 85234-2736

Mailing address

4001 E Baseline Rd Ste 102
Gilbert, AZ 85234-2736
Phone (480) 565-8045

Other practice location 1

1900 N Higley Rd
Gilbert, AZ 85234-1604
Phone (480) 981-2400

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121203000188 AZ Practitioner - Certified Registered Nurse Anesthetist (Crna) 1951553627 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Arlington Anesthesia Group PLLCGroup PAC ID 2860798303, 35 clinicians
Reddy Gi AssociatesGroup PAC ID 1557407459, 18 clinicians
Greater Anesthesia SolutionsGroup PAC ID 9234357906, 210 clinicians

Practice addresses (Care Compare)

220 S 63Rd St
Mesa, AZ 85206-1619
Phone (480) 641-3937

5555 E Baseline Rd
Mesa, AZ 85206-4709
Phone (480) 393-0575

5656 S Power Rd
Gilbert, AZ 85295-8480
Phone (480) 984-2000

Hospital & facility affiliations

  • Banner Ironwood Medical Center Hospital, Queen Creek, AZ, CCN 030130

Merit-based Incentive Payment System (MIPS)

Final score
63.31 of 100Reported as group
Quality
74.88
Improvement activities
0
Cost
73.76

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
CRNA0889AZMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Reddy Gi Associates CurrentSince Aug 1, 2024 Accepting new patients
Reddy Gi Associates CurrentSince Aug 1, 2024 Accepting new patients
Arlington Anesthesia Group, PLLC CurrentSince Apr 1, 2021 Accepting new patients
Central Arizona Gi & Liver Institute LLC CurrentSince Aug 1, 2024 Accepting new patients
Gateway Anesthesia and Pain Associates PLLC Nurse Anesthetist, Certified Registered CurrentSince Dec 1, 2012 Accepting new patients
Greater Anesthesia Solutions Nurse Anesthetist, Certified Registered CurrentSince Feb 1, 2017 Accepting new patients

Locations

1800 E Florence Blvd
Casa Grande, AZ 85122
Phone (520) 381-6285

604 W Warner Rd
Ste D1
Chandler, AZ 85225
Phone (480) 393-5075

4001 E Baseline Rd
#102103
Gilbert, AZ 85234

5656 S Power Rd
Gilbert, AZ 85295
Phone (480) 840-3733

4001 E Baseline Rd
Ste 102
Gilbert, AZ 85234
Phone (480) 565-8045

1900 N Higley Rd
Gilbert, AZ 85234
Phone (480) 543-2000

4001 E Baseline Rd
Gilbert, AZ 85234
Phone (480) 926-6200

220 S 63rd St
Mesa, AZ 85206
Phone (480) 641-3937

1301 S Crismon Rd
#C
Mesa, AZ 85209

4838 E Baseline Rd
Ste 108
Mesa, AZ 85206
Phone (480) 981-2400

5555 E Baseline Rd
Mesa, AZ 85206
Phone (480) 393-5075

1301 S Crismon Rd
Mesa, AZ 85209
Phone (480) 358-6300

1800 E Van Buren St
Phoenix, AZ 85006
Phone (602) 251-8100

Organizations & group practices 6

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 1

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": "1350604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733875200000",
    "number": "1851644405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4001 E BASELINE RD STE 102",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852342736",
            "telephone_number": "480-565-8045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4001 E BASELINE RD STE 102",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852342736",
            "telephone_number": "480-565-8045"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1900 N Higley Rd",
            "address_purpose": "LOCATION",
            "city": "Gilbert",
            "state": "AZ",
            "postal_code": "852341604",
            "country_code": "US",
            "telephone_number": "480-981-2400",
            "fax_number": "480-981-2407",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "BRAD",
        "middle_name": "MICHAEL",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-10-19",
        "last_updated": "2024-12-11",
        "certification_date": "2024-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "AZ",
            "license": "CRNA0889",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gilbert, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2024; 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.