Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.

NPI 1093765778

Individual provider · NPI 1093765778 Deactivated

This NPI was deactivated on September 11, 2026. The record is kept for reference and should not be used for billing or referrals.

NPI 1093765778 is registered under Certified Registered Nurse Anesthetist (CRNA). Qualified in 1991, 35 years ago. Practices with Ias Arizona PLLC, a 127-clinician group and accepts Medicare assignment.

Years since qualifying
35

Practice location Incomplete address

The federal record is missing the street or ZIP for this provider.

Specialties & licences

Record details

NPI number1093765778
Entity typeIndividual (Type 1)
NPI enumerated—
Last updated in NPPES—

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCERTIFIED REGISTERED NURSE ANESTHETIST (CRNA)
Medical schoolOTHER
Graduated 1991 (35 years in practice)
Group practice Ias Arizona Pllc — 127 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Medicare patients and services, 2024

From the CMS Medicare Physician & Other Practitioners file for calendar year 2024. It counts Original Medicare patients only, so a practice that mostly sees Medicare Advantage or privately insured patients looks smaller here than it is.

Medicare patients45
Services billed 48 a service is one billed item, such as a visit, a test or a procedure
Average patient age74

Dollar amounts are not shown. What Medicare pays a practice is gross billings, before staff, premises and tax and including the cost of any drugs it administers, so it is not what a clinician earns.

Practises at

Facilities the CMS Facility Affiliation file lists for this clinician.

Colleagues at Ias Arizona PLLC

Clinicians the CMS Doctors & Clinicians file lists under the same group practice. CMS counts 127 clinicians in the practice; 12 are shown here.