MEDICARE: PRAXIS ANESTHESIA KRAVCHENKO GROUP PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207L00000X	Anesthesiology Physician
2	367500000X	Certified Registered Nurse Anesthetist

General Provider Information

NPI Number	:	1023956430
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PRAXIS ANESTHESIA KRAVCHENKO GROUP PC

Provider Business Mailing Address
First Line	:	2550 E ROSE GARDEN LN UNIT 71850
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85050-7734
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	8530 W SUNSET RD STE 100
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89113-2244
Country	:	US
Telephone Number	:	702-789-5700
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	HEATHER HARRIS
Credential	:
Telephone Number	:	602-619-4509

Provider Enumeration Date	:	03/24/2026
Last Update Date	:	03/25/2026

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