NPIMap

Organization Active NPI

Prescott Anesthesia PLLC

  • Anesthesiology Physician
  • Prescott, AZ
National Provider Identifier
1962409185
Registry record updated Nov 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
PRESCOTT ANESTHESIA PLLC
Practice address
1003 Willow Creek Rd
Prescott, AZ 86301-1641
Phone
(928) 771-5393
Fax
(928) 771-5274
NPI assigned
Jul 1, 2005
Last updated
Nov 12, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2025

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

Authorized official

Name
Dr. Paul L Braithwaite, DONPI 1184616344
Title
Administrative Member
Phone
(928) 771-5232

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
Anesthesiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207L00000X AZ Primary

Addresses

Primary practice location

1003 Willow Creek Rd
Prescott, AZ 86301-1641

Mailing address

2425 W Bard Ranch Rd
Prescott, AZ 86305-4706
Phone (928) 771-5232

Other names 1

  • Prescott Anesthesia LLC Former legal business name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040327000221 AZ Part B Supplier - Clinic/Group Practice 4385536929 Receives reassigned benefits from 16 practitioners
Practice locations: Prescott, AZ; Prescott Valley, AZ

National Provider Directory

National Provider Directory

Locations

811 Ainsworth Dr
Prescott, AZ 86301
Phone (928) 771-5282

Practitioners & affiliated clinicians

Practitioners 29

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 29

NPI Registry JSON

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

{
    "created_epoch": "1120176000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1762905600000",
    "number": "1962409185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2425 W BARD RANCH RD",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863054706",
            "telephone_number": "928-771-5232",
            "fax_number": "928-771-5274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1003 WILLOW CREEK RD",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863011641",
            "telephone_number": "928-771-5393",
            "fax_number": "928-771-5274"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRESCOTT ANESTHESIA PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-01",
        "last_updated": "2025-11-12",
        "certification_date": "2025-11-12",
        "status": "A",
        "authorized_official_last_name": "BRAITHWAITE",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "ADMINISTRATIVE MEMBER",
        "authorized_official_telephone_number": "928-771-5232",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology",
            "state": "AZ",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Prescott Anesthesia LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Prescott, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2025; 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.