Individual provider Active NPI

Brian Alan Stark, CRNA

  • Certified Registered Nurse Anesthetist
  • Halethorpe, MD
National Provider Identifier
1093745093
Registry record updated Oct 25, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
R083302 Issued in MD
Practice address
5604 Friendship Rd
Halethorpe, MD 21227
Phone
(410) 242-8728
Fax
(410) 242-8728
NPI assigned
Jul 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2011

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 R083302 MD Primary

Addresses

Primary practice location

5604 Friendship Rd
Halethorpe, MD 21227

Mailing address

5604 Friendship Rd
Halethorpe, MD 21227
Phone (410) 242-8728

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040414001707 MD Practitioner - Certified Registered Nurse Anesthetist (Crna) 1759376353 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Lifebridge Community Gastroenterology, LLC CurrentSince Mar 1, 2014 Accepting new patients
Dr Wendy Kloesz, M.D., P.a Current Accepting new patients
Pikesville MD Endoscopy ASC LLC Current Accepting new patients
North American Partners in Anesthesia Maryland LLC PastSince Jul 10, 2022 Accepting new patients
Capital Anesthesia Partners, LLC Past Accepting new patients
Warren H Macleod C R N a PA Nurse Anesthetist, Certified Registered Past Accepting new patients
Rest Assured, P.a. Nurse Anesthetist, Certified Registered PastSince Oct 1, 1999 Accepting new patients
Endocentre at Quarterfield Station Past Accepting new patients

Locations

7704 Quarterfield Rd
Ste A
Glen Burnie, MD 21061
Phone (410) 863-4899

23 Crossroads Dr
Ste 100
Owings Mills, MD 21117
Phone (410) 356-0300

1838 Greene Tree Rd
Ste 180
Pikesville, MD 21208
Phone (410) 358-1800

5401 Old Court Rd
Randallstown, MD 21133
Phone (301) 337-2727

Organizations & group practices 8

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": "1151971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1319500800000",
    "number": "1093745093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5604 FRIENDSHIP RD",
            "city": "HALETHORPE",
            "state": "MD",
            "postal_code": "21227",
            "telephone_number": "410-242-8728",
            "fax_number": "410-242-8728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5604 FRIENDSHIP RD",
            "city": "HALETHORPE",
            "state": "MD",
            "postal_code": "21227",
            "telephone_number": "410-242-8728",
            "fax_number": "410-242-8728"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STARK",
        "first_name": "BRIAN",
        "middle_name": "ALAN",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-04",
        "last_updated": "2011-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MD",
            "license": "R083302",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Halethorpe, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2011; 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.