Individual provider Active NPI

Jerome Nguyen

  • Certified Registered Nurse Anesthetist
  • Phoenix, AZ
National Provider Identifier
1972473817
Registry record updated Jun 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
329962 Issued in AZ
Practice address
7301 N 16TH St Ste 102
Phoenix, AZ 85020-5266
Phone
(480) 420-4027
NPI assigned
Nov 6, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 10, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 329962 AZ Primary
Student in an Organized Health Care Education/Training ProgramGroup: 193400000X SINGLE SPECIALTY GROUP 390200000X 329962 AZ

Addresses

Primary practice location

7301 N 16TH St Ste 102
Phoenix, AZ 85020-5266

Mailing address

1111 E McDowell Rd
Phoenix, AZ 85006-2612

Other practice location 1

1111 E McDowell Rd
Phoenix, AZ 85006-2612
Phone (602) 839-2000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260406002987 AZ Practitioner - Certified Registered Nurse Anesthetist (Crna) 4688149826 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anesthesia Partners and Management LLCGroup PAC ID 9931429198, 151 clinicians
Guide Anesthesia Az LLCGroup PAC ID 1355846106, 102 clinicians

Practice addresses (Care Compare)

1111 E McDowell Rd
Phoenix, AZ 85006-2612
Phone (480) 420-4027

6501 N 19TH Ave
Phoenix, AZ 85015-1646
Phone (602) 795-6020

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
329962AZMDCertified Registered Nurse Anesthetist

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 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": "1762387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781049600000",
    "number": "1972473817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 E MCDOWELL RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850062612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7301 N 16TH ST STE 102",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850205266",
            "telephone_number": "480-420-4027"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1111 E McDowell Rd",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850062612",
            "country_code": "US",
            "telephone_number": "602-839-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "JEROME",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-11-06",
        "last_updated": "2026-06-10",
        "certification_date": "2026-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "AZ",
            "license": "329962",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "AZ",
            "license": "329962",
            "primary": false
        }
    ],
    "identifiers": [],
    "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 Jun 10, 2026; 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.