Individual provider Active NPI

Mark R Patin, CRNA

  • Certified Registered Nurse Anesthetist
  • Lafayette, LA
National Provider Identifier
1083726582
Registry record updated Jul 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
03821 Issued in LA
Practice address
611 Saint Landry St
Lafayette, LA 70506-4627
Phone
(337) 289-2966
Fax
(337) 289-2776
NPI assigned
Aug 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 03821 LA Primary
Certified Registered Nurse Anesthetist 367500000X AP03821 LA

Addresses

Primary practice location

611 Saint Landry St
Lafayette, LA 70506-4627

Mailing address

PO Box 53864
Lafayette, LA 70505-3864
Phone (337) 289-2966

Other practice location 1

4801 Ambassador Caffery Pkwy
Lafayette, LA 70508-6917
Phone (337) 470-2574

Other identifiers 1

IdentifierTypeStateIssuer
1108880MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040505000636 LA Practitioner - Certified Registered Nurse Anesthetist (Crna) 2163410309 Reassigns benefits to 4 organizations

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
Los Anesthesia Services LLCGroup PAC ID 0345760666, 10 clinicians
Youngs Professional Services LLCGroup PAC ID 2163524992, 297 clinicians

Practice addresses (Care Compare)

300 E Bluebird Dr
Lafayette, LA 70508
Phone (337) 889-3001

443 Heymann Blvd
Lafayette, LA 70503-2630
Phone (337) 269-1126

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
03821LAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Sanford Anesthesia Services, LLC Nurse Anesthetist, Certified Registered CurrentSince Mar 24, 2023 Accepting new patients
Los Orthopaedic and Spine Surgery Center, LLC CurrentSince Apr 4, 2025 Accepting new patients
Los Anesthesia Services LLC CurrentSince Apr 4, 2025 Accepting new patients
Youngs Professional Services LLC Nurse Anesthetist, Certified Registered CurrentSince Nov 1, 2016 Accepting new patients
Precision Anesthesia of Lafayette LLC Nurse Anesthetist, Certified Registered CurrentSince Dec 1, 2018 Accepting new patients
DRS Burleigh, Dupleix and Rees Past Accepting new patients
Lourdes Pathologists Apmc Past Accepting new patients

Locations

3448 Highway 190
Eunice, LA 70535
Phone (337) 546-6237

1105 Kaliste Saloom Rd
Lafayette, LA 70508
Phone (225) 296-0041

120 Rue Louis Xiv
Lafayette, LA 70508
Phone (337) 233-6665

1211 Coolidge Blvd
Lafayette, LA 70503
Phone (337) 234-9191

443 Heymann Blvd
Lafayette, LA 70503
Phone (337) 269-1126

1100 Andre St
Ste 300
New Iberia, LA 70563
Phone (337) 364-9225

Organizations & group practices 7

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": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784592000000",
    "number": "1083726582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 53864",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705053864",
            "telephone_number": "337-289-2966",
            "fax_number": "337-289-2776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 SAINT LANDRY ST",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705064627",
            "telephone_number": "337-289-2966",
            "fax_number": "337-289-2776"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4801 Ambassador Caffery Pkwy",
            "address_purpose": "LOCATION",
            "city": "Lafayette",
            "state": "LA",
            "postal_code": "705086917",
            "country_code": "US",
            "telephone_number": "337-470-2574",
            "fax_number": "337-470-2605",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PATIN",
        "first_name": "MARK",
        "middle_name": "R",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2026-07-21",
        "certification_date": "2026-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "LA",
            "license": "03821",
            "primary": true
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "LA",
            "license": "AP03821",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1108880",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lafayette, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2026; 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.