MEDICARE: PRIME ANESTHESIA PARTNERS LLC

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	:	1710838602
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PRIME ANESTHESIA PARTNERS LLC

Provider Business Mailing Address
First Line	:	1902 W UNION HILLS DR # 41068
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85027-5984
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	838 W ELLIOT RD # 102
Second Line	:
City	:	GILBERT
State	:	AZ
Zip	:	85233-5162
Country	:	US
Telephone Number	:	480-374-7354
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	JAMES SULLIVAN
Credential	:
Telephone Number	:	619-980-6951

Provider Enumeration Date	:	02/05/2026
Last Update Date	:	02/05/2026

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Directions to “PRIME ANESTHESIA PARTNERS LLC ” Practice Location

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