Individual provider Active NPI

Kristen Marll

  • Certified Registered Nurse Anesthetist
  • Baltimore, MD
National Provider Identifier
1003273400
Registry record updated Dec 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
R189396 Issued in MD
Practice address
2401 W Belvedere Ave
Baltimore, MD 21215-5216
Phone
(410) 601-5209
NPI assigned
Jan 15, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X R189396 MD Primary

Addresses

Primary practice location

2401 W Belvedere Ave
Baltimore, MD 21215-5216

Mailing address

2401 W Belvedere Ave
Baltimore, MD 21215-5216
Phone (410) 601-5209

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20160215000488 MD Practitioner - Certified Registered Nurse Anesthetist (Crna) 0941504849 Reassigns benefits to 4 organizations
I20230217002306 DC Practitioner - Certified Registered Nurse Anesthetist (Crna) 0941504849 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lifebridge Anesthesia Associates LLCGroup PAC ID 2062514888, 109 clinicians

Practice addresses (Care Compare)

2401 E Belvedere Ave
Baltimore, MD 21215-5216
Phone 80051653155104

Hospital & facility affiliations

  • Sinai Hospital of Baltimore Hospital, Baltimore, MD, CCN 210012

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
R189396MDMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
First Colonies Anesthesia Associates, LLC Nurse Anesthetist, Certified Registered CurrentSince Dec 20, 2022 Accepting new patients
Lifebridge Anesthesia Associates, LLC Nurse Anesthetist, Certified Registered CurrentSince Jun 1, 2023 Accepting new patients
North American Partners in Anesthesia Maryland LLC CurrentSince Feb 1, 2016 Accepting new patients
Anesthesia Company, LLC Nurse Anesthetist, Certified Registered CurrentSince Nov 15, 2020 Accepting new patients

Locations

851 Trafalgar Ct
Ste 200E
Maitland, FL 32751
Phone (321) 422-7155

2001 Medical Pkwy
Annapolis, MD 21401
Phone (410) 280-5601

2401 W Belvedere Ave
Baltimore, MD 21215

301 Hospital Dr
Glen Burnie, MD 21061
Phone (410) 787-4565

5401 Old Court Rd
Randallstown, MD 21133
Phone (301) 337-2727

11210 Old Georgetown Rd
Rockville, MD 20852
Phone (301) 881-7770

11210 Old Georgetown Rd
#12202
Rockville, MD 20852
Phone (301) 881-7770

1500 Forest Glen Rd
Silver Spring, MD 20910
Phone (301) 754-7230

8322 Bellona Ave
Ste 201
Towson, MD 21204
Phone (410) 337-2688

68 S Service Rd
Ste 350
Melville, NY 11747
Phone (516) 945-3107

Organizations & group practices 4

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 2

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": "1452816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671062400000",
    "number": "1003273400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2401 W BELVEDERE AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212155216",
            "telephone_number": "410-601-5209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2401 W BELVEDERE AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212155216",
            "telephone_number": "410-601-5209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARLL",
        "first_name": "KRISTEN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-01-15",
        "last_updated": "2022-12-15",
        "certification_date": "2022-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MD",
            "license": "R189396",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2022; 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.