Pennie Marie Marko, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

4704266251 Issued in MI

Practice address

2025 Hunt Club Dr
Grosse Pointe Woods, MI 48236-1703

Phone

(586) 292-2943

NPI assigned

Dec 13, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Ms. Pennie Marie Osantowski Former name

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Henry Ford Health St. John HospitalGroup PAC ID 3173424082, 332 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: pmarko310985@direct.hfhs.org

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.

• Henry Ford Health St. John Hospital

  • Certified Registered Nurse Anesthetist
  • Detroit, MI
  • NPI 1598896995

  Nurse Anesthetist, Certified Registered

  Medicare reassignment Care Compare group NPD
• Southfield Rehabilitation Company

  • General Acute Care Hospital
  • Southfield, MI
  • NPI 1790785095

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• William Beaumont Hospital

  • Hospitalist Physician
  • Royal Oak, MI
  • NPI 1811044878

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Henry Ford West Bloomfield Hospital

  • Anesthesiology Physician
  • West Bloomfield, MI
  • NPI 1518104686
  Medicare reassignment
• Southfield Rehabilitation Company

  • Diagnostic Radiology Physician
  • Dearborn, MI
  • NPI 1285906792
  NPD
• William Beaumont Hospital

  • General Acute Care Hospital
  • Grosse Pointe, MI
  • NPI 1932396017
  NPD
• Henry Ford Health St. John Hospital

  • General Acute Care Hospital
  • Chicago, IL
  • NPI 1023088168
  NPD

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

{
    "created_epoch": "1355356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1401926400000",
    "number": "1043556442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2025 HUNT CLUB DR",
            "city": "GROSSE POINTE WOODS",
            "state": "MI",
            "postal_code": "482361703",
            "telephone_number": "586-292-2943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2025 HUNT CLUB DR",
            "city": "GROSSE POINTE WOODS",
            "state": "MI",
            "postal_code": "482361703",
            "telephone_number": "586-292-2943"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARKO",
        "first_name": "PENNIE",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-12-13",
        "last_updated": "2014-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MI",
            "license": "4704266251",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MI",
            "license": "4704266251",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PENNIE",
            "last_name": "OSANTOWSKI",
            "middle_name": "MARIE",
            "prefix": "MS.",
            "credential": "RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Mary A Mandziara, NP
• Manor Pharmacy & Surgical Supply
• Lisa Allyn Manz Dulac, MD
• Marivic D. Massand MD,PLLC
• Danielle Marie Marken
• Kayla Marlow
• Nathan E Maroney, LLPC
• Angela Martin
• Marivic D Massand, M.D.
• Kaytlin Mather, NP

• Certified Registered Nurse Anesthetist in Grosse Pointe Woods, MI
• Providers in Grosse Pointe Woods, MI by specialty
• Certified Registered Nurse Anesthetist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2014; 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.