Mark Leroy Vanderweide, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

4704293836 Issued in MI

Practice address

14700 Lake Shore Dr
Charlevoix, MI 49720-1999

Phone

(231) 547-4024

NPI assigned

Sep 1, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Munson Healthcare Charlevoix HospitalGroup PAC ID 4284528035, 57 clinicians

Munson Healthcare CadillacGroup PAC ID 6305161514, 104 clinicians

Munson Healthcare Otsego Memorial HospitalGroup PAC ID 8325942535, 126 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Charlevoix Area Hospital Hospital, Charlevoix, MI, CCN 231322
• Munson Healthcare Otsego Memorial Hospital Hospital, Gaylord, MI, CCN 230133

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Munson Healthcare Cadillac

  • Anesthesiology Physician
  • Cadillac, MI
  • NPI 1871991596

  Nurse Anesthetist, Certified Registered

  Medicare reassignment Care Compare group NPD
• Munson Healthcare Charlevoix Hospital

  • Pediatrics Physician
  • Charlevoix, MI
  • NPI 1326124058
  Medicare reassignment Care Compare group NPD
• Munson Healthcare Otsego Memorial Hospital

  • Certified Registered Nurse Anesthetist
  • Gaylord, MI
  • NPI 1376568865

  Nurse Anesthetist, Certified Registered

  Medicare reassignment Care Compare group NPD
• Munson Healthcare Cadillac

  • Psychiatry Physician
  • Traverse City, MI
  • NPI 1720955081
  NPD
• Munson Healthcare Charlevoix Hospital

  • Certified Registered Nurse Anesthetist
  • Charlevoix, MI
  • NPI 1063598845

  Nurse Anesthetist, Certified Registered

  NPD
• Munson Healthcare Charlevoix Hospital

  • Family Medicine Physician
  • Charlevoix, MI
  • NPI 1972367043
  NPD
• Munson Healthcare Otsego Memorial Hospital

  • Anesthesiology Physician
  • Gaylord, MI
  • NPI 1518982073
  NPD
• Munson Healthcare Otsego Memorial Hospital

  • Plastic Surgery Physician
  • Petoskey, MI
  • NPI 1770374530
  NPD
• Munson Healthcare Otsego Memorial Hospital

  • General Practice Physician
  • Gaylord, MI
  • NPI 1821064643
  NPD
• Munson Healthcare Cadillac

  • Surgery Physician
  • Cadillac, MI
  • NPI 1336547041
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Munson Healthcare Charlevoix Hospital

  • Critical Access Hospital
  • Charlevoix, MI
  • NPI 1346260692
  Care Compare affiliation
• Munson Healthcare Otsego Memorial Hospital

  • General Acute Care Hospital
  • Gaylord, MI
  • NPI 1124028972
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1661990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665532800000",
    "number": "1225758824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "854 DORROLL ST NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495054209",
            "telephone_number": "616-914-6532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14700 LAKE SHORE DR",
            "city": "CHARLEVOIX",
            "state": "MI",
            "postal_code": "497201999",
            "telephone_number": "231-547-4024"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDERWEIDE",
        "first_name": "MARK",
        "middle_name": "LEROY",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-09-01",
        "last_updated": "2022-10-12",
        "certification_date": "2022-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MI",
            "license": "4704293836",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Roderic E Tinney, M.D.
• Brendan Cedar Toton, MSW
• Tova Rogers MD Mfa PLLC
• Jilaine Towne-Patton, LPC
• Adam John Tsaloff
• Stephanie L Vanniman, LMSW
• Sherri S Vazales, M.D.
• Meghann Vincent
• Amy L Vipond, PTA
• Steven A Voci, O.D.

• Certified Registered Nurse Anesthetist in Charlevoix, MI
• Providers in Charlevoix, MI by specialty
• Certified Registered Nurse Anesthetist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 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.

Verify at the official NPI Registry.