Individual provider Active NPI

Myra F Mardis, CRNA

  • Certified Registered Nurse Anesthetist
  • Stanford, CA
National Provider Identifier
1164430062
Registry record updated Jun 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
95002717 Issued in CA
Practice address
300 Pasteur Dr
Stanford, CA 94305-2200
Phone
(650) 723-4000
NPI assigned
Aug 4, 2006
Last updated
Jun 8, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 8, 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 RN286402 OH
Certified Registered Nurse Anesthetist 367500000X 95002717 CA Primary

Addresses

Primary practice location

300 Pasteur Dr
Stanford, CA 94305-2200

Mailing address

300 Pasteur Dr
Stanford, CA 94305-2200
Phone (650) 723-4000

Other practice location 1

2222 Philadelphia Drive
Dayton, OH 45406-1891
Phone (937) 278-2612

Other identifiers 2

IdentifierTypeStateIssuer
000000354962OtherOHANTHEM
2540576MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN, KY, CA3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20120806000419 IN Practitioner - Certified Registered Nurse Anesthetist (Crna) 6305890419 Reassigns benefits to 1 organization
I20160210001751 KY Practitioner - Certified Registered Nurse Anesthetist (Crna) 6305890419 Reassigns benefits to 4 organizations
I20260515002171 CA Practitioner - Certified Registered Nurse Anesthetist (Crna) 6305890419 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anesthesia Dynamics LLCGroup PAC ID 3779832530, 883 clinicians
Anesthesiology Group Associates PCGroup PAC ID 0547233959, 47 clinicians

Practice addresses (Care Compare)

217 S 3Rd St
Danville, KY 40422-1823
Phone (853) 893-1000

3700 Washington Ave
Evansville, IN 47714-0541
Phone (812) 473-0181

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN286402OHMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesia Dynamics LLC Nurse Anesthetist, Certified Registered CurrentSince Dec 17, 2024 Accepting new patients
Anesthesiology Group Associates PC Nurse Anesthetist, Certified Registered CurrentSince Sep 1, 2018 Accepting new patients
Ad of Kentucky PLLC Nurse Anesthetist, Certified Registered CurrentSince Sep 17, 2025 Accepting new patients
Northstar Anesthesia of Kentucky, PLLC Nurse Anesthetist, Certified Registered CurrentSince Jan 2, 2016 Accepting new patients
Apollo Medical Group LLC Nurse Anesthetist, Certified Registered CurrentSince Oct 15, 2013 Accepting new patients
Commonwealth Anesthesia, PSC Nurse Anesthetist, Certified Registered CurrentSince Oct 1, 2022 Accepting new patients
Anesthesia Care Associates, LLC Nurse Anesthetist, Certified Registered PastSince Jan 4, 2012 Accepting new patients
Pediatric Anesthesia Associates of Dayton, Inc. Past Accepting new patients
Digestive Care of Evansville, PC Past Accepting new patients
Children's Anesthesia Group Inc Nurse Anesthetist, Certified Registered Past Accepting new patients
Consolidated Anesthesiologists Inc Nurse Anesthetist, Certified Registered Past Accepting new patients

Locations

3700 Washington Ave
Evansville, IN 47714
Phone (812) 232-0021

801 Saint Marys Dr
Ste 205W
Evansville, IN 47714
Phone (812) 477-6103

647 2nd St
Ste A
Jasper, IN 47546
Phone (812) 477-6103

1276 N Plaza Dr
Rockport, IN 47635
Phone (812) 649-2500

217 S 3rd St
Danville, KY 40422
Phone (859) 239-1000

310 S Limestone
Lexington, KY 40508
Phone (606) 252-6612

225 Abraham Flexner Way
Ste 700
Louisville, KY 40202
Phone (502) 562-0398

1099 Medical Center Cir
Mayfield, KY 42066
Phone (270) 251-4100

1000 Breckenridge St
Ste 100
Owensboro, KY 42303
Phone (270) 683-2751

1201 Pleasant Valley Rd
Owensboro, KY 42303
Phone (270) 417-2000

175 Hospital Dr
Winchester, KY 40391
Phone (859) 745-3500

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1154649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780876800000",
    "number": "1164430062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 PASTEUR DR",
            "city": "STANFORD",
            "state": "CA",
            "postal_code": "943052200",
            "telephone_number": "650-723-4000",
            "fax_number": "937-293-0960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 PASTEUR DR",
            "city": "STANFORD",
            "state": "CA",
            "postal_code": "943052200",
            "telephone_number": "650-723-4000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2222 Philadelphia Drive",
            "address_purpose": "LOCATION",
            "city": "Dayton",
            "state": "OH",
            "postal_code": "454061891",
            "country_code": "US",
            "telephone_number": "937-278-2612",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARDIS",
        "first_name": "MYRA",
        "middle_name": "F",
        "name_prefix": "Ms.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-04",
        "last_updated": "2026-06-08",
        "certification_date": "2026-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "OH",
            "license": "RN286402",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CA",
            "license": "95002717",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000354962",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2540576",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Stanford, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 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.