Individual provider Active NPI

Mark E Schulz, CRNA

  • Certified Registered Nurse Anesthetist
  • Watertown, SD
National Provider Identifier
1083643308
Registry record updated Aug 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
CRNA0510 Issued in SD
Practice address
401 9TH Ave NW
Watertown, SD 57201-1548
Phone
(605) 882-7000
Fax
(605) 882-7636
NPI assigned
Jun 30, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2023

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 CRNA0510 SD Primary

Addresses

Primary practice location

401 9TH Ave NW
Watertown, SD 57201-1548

Mailing address

401 9TH Ave NW
Watertown, SD 57201-1548
Phone (605) 882-7000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD, MN, ND3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20041103001300 SD Practitioner - Certified Registered Nurse Anesthetist (Crna) 1557323227 Reassigns benefits to 1 organization
I20120201000644 MN Practitioner - Certified Registered Nurse Anesthetist (Crna) 1557323227 Reassigns benefits to 4 organizations
I20220719003235 ND Practitioner - Certified Registered Nurse Anesthetist (Crna) 1557323227 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Prairie Lakes Health Care System IncGroup PAC ID 8628987823, 111 clinicians

Practice addresses (Care Compare)

401 9TH Ave NW
Watertown, SD 57201-1548
Phone (605) 882-7000

Hospital & facility affiliations

  • Prairie Lakes Healthcare System, Inc Hospital, Watertown, SD, CCN 430005

Merit-based Incentive Payment System (MIPS)

Final score
80 of 100Reported as group
Quality
60
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
88.64 of 100Reported as group
Quality
86.84
Promoting interoperability
100
Improvement activities
40
Cost
75.29

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
CRNA0510SDMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Lake Region Healthcare Corporation CurrentSince Oct 1, 2019 Accepting new patients
Lake Region Healthcare Corporation CurrentSince Oct 1, 2019 Accepting new patients
CCM Health Current Accepting new patients
TTB Services Prof LLC Nurse Anesthetist, Certified Registered CurrentSince Sep 1, 2023 Accepting new patients
Lake Region Healthcare Corporation CurrentSince Oct 1, 2019 Accepting new patients
Cssa, LLC Nurse Anesthetist, Certified Registered CurrentSince Jun 15, 2022 Accepting new patients
Lake Region Healthcare Corporation CurrentSince Oct 1, 2019 Accepting new patients
Prairie Lakes Health Care System Inc CurrentSince Aug 14, 2025 Accepting new patients

Locations

2600 Jefferson St
Ste 100
Alexandria, MN 56308
Phone (320) 335-2167

1411 Highway 79 E
Elbow Lake, MN 56531
Phone (218) 685-7300

649 State St NW
Evansville, MN 56326
Phone (218) 948-2040

712 S Cascade St
Fergus Falls, MN 56537

824 N 11th St
Montevideo, MN 56265
Phone (320) 269-8877

400 10th St E
Waconia, MN 55387

350 23rd Ave E
Ste 201
West Fargo, ND 58078
Phone (701) 356-4770

401 9th Ave NW
Watertown, SD 57201
Phone (605) 886-9317

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/e35355ac-dfca-48b9-9dd9-0b7c408c2a66/
  • Direct secure messaging: mschulz482416@direct.centracare.com

Organizations & group practices 9

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": "1151625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691539200000",
    "number": "1083643308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 9TH AVE NW",
            "city": "WATERTOWN",
            "state": "SD",
            "postal_code": "572011548",
            "telephone_number": "605-882-7000",
            "fax_number": "605-882-7636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 9TH AVE NW",
            "city": "WATERTOWN",
            "state": "SD",
            "postal_code": "572011548",
            "telephone_number": "605-882-7000",
            "fax_number": "605-882-7636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHULZ",
        "first_name": "MARK",
        "middle_name": "E",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-30",
        "last_updated": "2023-08-09",
        "certification_date": "2023-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "SD",
            "license": "CRNA0510",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Watertown, SD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2023; 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.