Individual provider Active NPI

Jonathan L Sorenson, CRNA

  • Certified Registered Nurse Anesthetist
  • Mount Vernon, IL
National Provider Identifier
1063516136
Registry record updated Jan 24, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
209000414 Issued in IL
Practice address
2 Good Samaritan Way
Suite 205
Mount Vernon, IL 62864-2408
Phone
(618) 241-1108
Fax
(618) 241-3805
NPI assigned
Sep 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2014

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 209000414 IL Primary

Addresses

Primary practice location

2 Good Samaritan Way
Suite 205
Mount Vernon, IL 62864-2408

Mailing address

4227 Lincolnshire Dr
Mount Vernon, IL 62864-2157

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, MO2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20050914000749 IL Practitioner - Certified Registered Nurse Anesthetist (Crna) 2860425451 Reassigns benefits to 3 organizations
I20220201002740 MO Practitioner - Certified Registered Nurse Anesthetist (Crna) 2860425451

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Good Samaritan Regional Health CenterGroup PAC ID 1658272059, 155 clinicians
Anesthesia Associates of Southern Illinois Surgery Center LLCGroup PAC ID 0648555433, 22 clinicians

Practice addresses (Care Compare)

1 Good Samaritan Way
Mount Vernon, IL 62864-2402
Phone (557) 203-1601

2 Good Samaritan Way
Suite 200
Mount Vernon, IL 62864-2476
Phone (618) 899-3869

Hospital & facility affiliations

  • Good Samaritan Regional HLTH Center Hospital, Mount Vernon, IL, CCN 140046

Merit-based Incentive Payment System (MIPS)

Final score
98.77 of 100Reported as group
Quality
85.58
Promoting interoperability
100
Improvement activities
40
Cost
76.99

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesia Associates of Southern Illinois Surgery Center LLC Nurse Anesthetist, Certified Registered CurrentSince Feb 12, 2017 Accepting new patients
St. Mary'S Hospital, Centralia, Illinois CurrentSince Jan 4, 2017 Accepting new patients
St. Mary'S Hospital, Centralia, Illinois CurrentSince Jan 4, 2017 Accepting new patients
Good Samaritan Regional Health Center CurrentSince May 4, 2025 Accepting new patients
St. Mary'S Hospital, Centralia, Illinois Current Accepting new patients
Jefferson Memorial Surgical Partners LLC Past Accepting new patients
HSHS Holy Family Hospital Inc Past Accepting new patients
Acuity Anesthesiology LLC Past Accepting new patients
Mercy Hospital Jefferson Past Accepting new patients

Locations

400 N Pleasant Ave
Centralia, IL 62801
Phone (618) 436-5221

7420 Solutions Ctr
Chicago, IL 60677
Phone (314) 989-3155

5 Good Samaritan Way
Mount Vernon, IL 62864
Phone (557) 203-1601

4225 Lincolnshire Dr
Ste B
Mount Vernon, IL 62864

605 N 12th St
Mount Vernon, IL 62864
Phone (618) 241-2200

1 Good Samaritan Way
Mount Vernon, IL 62864
Phone (618) 242-4600

2 Good Samaritan Way
Ste 200
Mount Vernon, IL 62864
Phone (618) 899-3869

2 Good Samaritan Way
Ste 205
Mount Vernon, IL 62864
Phone (618) 241-1108

Organizations & group practices 12

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 1

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": "1157932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1390521600000",
    "number": "1063516136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4227 LINCOLNSHIRE DR",
            "city": "MOUNT VERNON",
            "state": "IL",
            "postal_code": "628642157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 GOOD SAMARITAN WAY",
            "address_2": "SUITE 205",
            "city": "MOUNT VERNON",
            "state": "IL",
            "postal_code": "628642408",
            "telephone_number": "618-241-1108",
            "fax_number": "618-241-3805"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SORENSON",
        "first_name": "JONATHAN",
        "middle_name": "L",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-11",
        "last_updated": "2014-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IL",
            "license": "209000414",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Vernon, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 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.