Individual provider Active NPI

Mary R Tunnessen, CRNA

  • Certified Registered Nurse Anesthetist
  • E Stroudsburg, PA
National Provider Identifier
1023114766
Registry record updated Apr 13, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
RN318234L Issued in PA
Practice address
206 E Brown St
E Stroudsburg, PA 18301-3006
Phone
(570) 421-4000
NPI assigned
Sep 16, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2015

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 RN318234L PA Primary

Addresses

Primary practice location

206 E Brown St
E Stroudsburg, PA 18301-3006

Mailing address

3998 Fair Ridge Dr
Ste 300
Fairfax, VA 22033-2921
Phone (703) 295-9360

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, NC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20040209000278 PA Practitioner - Certified Registered Nurse Anesthetist (Crna) 6608760004 Reassigns benefits to 2 organizations
I20210721001121 NC Practitioner - Certified Registered Nurse Anesthetist (Crna) 6608760004 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carolina Anesthesia Associates PAGroup PAC ID 1456251057, 67 clinicians
Carolina Regional Anesthesia PLLCGroup PAC ID 5496921769, 51 clinicians

Practice addresses (Care Compare)

1515 Doctors Cir
Wilmington, NC 28401-7403
Phone (910) 763-5182

5115 Oleander Dr
Wilmington, NC 28403-7018
Phone (910) 362-1011

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5870NCMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Lehigh Valley Anesthesia Services, P. C. Anesthesiology CurrentSince Oct 30, 2017 Accepting new patients
Carolina Anesthesia Associates PA Anesthesiology CurrentSince Jul 1, 2021 Accepting new patients
North American Partners in Anesthesia, Pennsylvania , LLC Anesthesiology CurrentSince Apr 11, 2015 Accepting new patients
Carolina Regional Anesthesia PLLC Anesthesiology CurrentSince Jul 1, 2021 Accepting new patients
NMG Southpark Services, LLC Nurse Anesthetist, Certified Registered CurrentSince Oct 27, 2024 Accepting new patients

Locations

6035 Fairview Rd
Charlotte, NC 28210
Phone (336) 718-2078

2041 Valleygate Dr
Fayetteville, NC 28304
Phone (910) 323-5203

3312 Battleground Ave
Greensboro, NC 27410
Phone (336) 282-5000

242A 9th Avenue Dr NE
Hickory, NC 28601
Phone (828) 327-6673

13 Medical Campus Dr NW
#101
Supply, NC 28462
Phone (910) 721-4300

5115 Oleander Dr
Wilmington, NC 28403
Phone (910) 362-1011

1515 Doctors Cir
Wilmington, NC 28401
Phone (910) 763-5182

1200 S Cedar Crest Blvd
Allentown, PA 18103
Phone (484) 862-3200

206 E Brown St
East Stroudsburg, PA 18301
Phone (570) 420-4951

420 S Jackson St
Pottsville, PA 17901
Phone (570) 621-5000

700 E Norwegian St
Pottsville, PA 17901
Phone (570) 621-4000

Organizations & group practices 5

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1158364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1428883200000",
    "number": "1023114766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3998 FAIR RIDGE DR",
            "address_2": "STE 300",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220332921",
            "telephone_number": "703-295-9360",
            "fax_number": "703-766-9725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "206 E BROWN ST",
            "city": "E STROUDSBURG",
            "state": "PA",
            "postal_code": "183013006",
            "telephone_number": "570-421-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUNNESSEN",
        "first_name": "MARY",
        "middle_name": "R",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-16",
        "last_updated": "2015-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "PA",
            "license": "RN318234L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in E Stroudsburg, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2015; 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.