Active NPI
Mark A Sudimak, CRNA
- Certified Registered Nurse Anesthetist
- Kent, OH
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 019368
- Practice address
- 4591 Creekside Dr
Kent, OH 44240-7376 - Phone
- (330) 524-9937
- NPI assigned
- Oct 25, 2016
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 357443 | OH | |
| Certified Registered Nurse Anesthetist | 367500000X | 019368 | OH | Primary |
Addresses
Primary practice location
4591 Creekside Dr
Kent, OH 44240-7376
Mailing address
2313 S Hametown Rd
Copley, OH 44321-2454
Phone (330) 524-9937
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | Copley |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OH
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- Other, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
525 E Market St
Akron, OH 44304-1619
Phone (330) 375-3000
Hospital & facility affiliations
- Summa Health System
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 357443 | OH | MD | Registered Nurse |
| 019368 | OH | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dayton Anesthesia & Pain Services, LLC | Nurse Anesthetist, Certified Registered | Current | Accepting new patients |
| Southwest Ohio Anesthesia Consultants LLC | Nurse Anesthetist, Certified Registered | Current | Accepting new patients |
| Southwest Ohio Anesthesia Consultants LLC | Nurse Anesthetist, Certified Registered | Current | Accepting new patients |
Locations
1643 NW 136th Ave
Ste 100
Sunrise, FL 33323
Phone (865) 500-1325
525 E Market St
Akron, OH 44304
Phone (330) 375-6350
7500 State Rd
Cincinnati, OH 45255
Phone (513) 624-4034
405 W Grand Ave
Dayton, OH 45405
Phone (937) 226-3200
Organizations & group practices 3
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.
-
- Anesthesiology Physician
- Dayton, OH
- NPI 1629401898
Nurse Anesthetist, Certified Registered
-
- Anesthesiology Physician
- Cincinnati, OH
- NPI 1588645188
Nurse Anesthetist, Certified Registered
-
- Anesthesiology Physician
- Cincinnati, OH
- NPI 1255768107
Nurse Anesthetist, Certified Registered
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Substance Use Disorder Rehabilitation Clinic/Center
- Canton, OH
- NPI 1295036762
Hospital
-
- General Acute Care Hospital
- Akron, OH
- NPI 1396765681
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1477353600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1661212800000",
"number": "1174075196",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2313 S HAMETOWN RD",
"city": "COPLEY",
"state": "OH",
"postal_code": "443212454",
"telephone_number": "330-524-9937"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4591 CREEKSIDE DR",
"city": "KENT",
"state": "OH",
"postal_code": "442407376",
"telephone_number": "330-524-9937"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SUDIMAK",
"first_name": "MARK",
"middle_name": "A",
"name_prefix": "Mr.",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-10-25",
"last_updated": "2022-08-23",
"certification_date": "2022-08-23",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "OH",
"license": "357443",
"primary": false
},
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "OH",
"license": "019368",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "Copley",
"affiliation": "N",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "Copley",
"address_1": "2313 S Hametown Rd",
"city": "Copley",
"state": "OH",
"country_code": "US",
"postal_code": "443212454",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Kent, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2022; 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.