Individual provider Active NPI

Mark Prudente, CRNA

  • Certified Registered Nurse Anesthetist
  • Camden, NJ
National Provider Identifier
1326539305
Registry record updated Sep 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
26NJ15160500 Issued in NJ
Practice address
1 Cooper PLZ Dept of
Camden, NJ 08103-1461
Phone
(856) 342-2425
NPI assigned
May 24, 2018
Last updated
Sep 30, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2024

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 RN589307 PA
Certified Registered Nurse Anesthetist 367500000X 26NJ15160500 NJ Primary

Addresses

Primary practice location

1 Cooper PLZ Dept of
Camden, NJ 08103-1461

Mailing address

1 Federal St Ste 200
Camden, NJ 08103-1088
Phone (848) 288-6935

Other practice location 1

51 N 39th St
Philadelphia, PA 19104-2640
Phone (215) 662-8244

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, NJ2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20180608000045 PA Practitioner - Certified Registered Nurse Anesthetist (Crna) 1254696537 Reassigns benefits to 6 organizations
I20241014000032 NJ Practitioner - Certified Registered Nurse Anesthetist (Crna) 1254696537 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northstar Anesthesia of Pennsylvania LLCGroup PAC ID 5092941161, 65 clinicians

Practice addresses (Care Compare)

1500 Lansdowne Ave
Darby, PA 19023-1291
Phone (610) 237-4000

1995 Technology Pkwy
Mechanicsburg, PA 17050-8522
Phone (717) 782-3282

454 Enterprise Dr
Royersford, PA 19468-1200
Phone (610) 495-3330

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University of Penn-Medical Group Current Accepting new patients
Cooper Anesthesia Associates, PC CurrentSince Oct 1, 2024 Accepting new patients
Clinical Care Associates of the University of Pennsylvania Health Syst CurrentSince Jul 2, 2021 Accepting new patients
Tower Health Medical Group Current Accepting new patients
Tower Health Medical Group CurrentSince Jun 1, 2024 Accepting new patients
North American Partners in Anesthesia, Pennsylvania , LLC Nurse Anesthetist, Certified Registered CurrentSince Feb 16, 2020 Accepting new patients
Clinical Care Associates of the University of Pennsylvania Health CurrentSince Jul 2, 2021 Accepting new patients
Northstar Anesthesia of Pennsylvania, LLC Nurse Anesthetist, Certified Registered CurrentSince Aug 1, 2024 Accepting new patients
Upmc Pinnacle Anesthesia Services, LLC CurrentSince Aug 1, 2025 Accepting new patients
Tower Health Medical Group CurrentSince Jun 1, 2024 Accepting new patients
University of Penn-Medical Group CurrentSince Jul 1, 2018 Accepting new patients
Upmc Pinnacle Anesthesia Services, LLC Nurse Anesthetist, Certified Registered CurrentSince Aug 1, 2025 Accepting new patients
University of Penn-Medical Group CurrentSince Jul 1, 2018 Accepting new patients
Clinical Care Associates of the University of Pennsylvania Health Current Accepting new patients

Locations

1 Cooper Plz
Camden, NJ 08103
Phone (856) 342-2425

400 W Route 38
Moorestown, NJ 08057
Phone (856) 270-4000

501 Fellowship Rd
Ste 102
Mount Laurel, NJ 08054
Phone (856) 380-1768

900 Centennial Blvd
Ste E
Voorhees, NJ 08043
Phone (609) 325-6505

218C Sunset Rd
Willingboro, NJ 08046
Phone (609) 877-0400

1000 Dutch Ridge Rd
Beaver, PA 15009
Phone (724) 728-7000

130 S Bryn Mawr Ave
Bryn Mawr, PA 19010
Phone (484) 337-3000

1500 Lansdowne Ave
Darby, PA 19023
Phone (610) 237-4561

206 E Brown St
East Stroudsburg, PA 18301
Phone (570) 420-4951

111 S Front St
Harrisburg, PA 17101
Phone (717) 782-3282

1995 Technology Pkwy
Mechanicsburg, PA 17050
Phone (717) 791-2600

3624 Market St
Fl 2
Philadelphia, PA 19104
Phone (215) 615-3669

8835 Germantown Ave
Philadelphia, PA 19118
Phone (215) 248-8227

701 E Marshall St
West Chester, PA 19380
Phone (610) 431-5000

301 S 7th Ave
Ste 130
West Reading, PA 19611
Phone (610) 988-4630

420 S 5th Ave
West Reading, PA 19611
Phone (484) 628-3637

2610 Keiser Blvd
Wyomissing, PA 19610
Phone (484) 628-9127

777 Township Line Rd
Ste 200
Yardley, PA 19067
Phone (215) 860-0775

Organizations & group practices 14

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.

View all 14

Hospital & facility affiliations 8

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": "1527120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727654400000",
    "number": "1326539305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 FEDERAL ST STE 200",
            "city": "CAMDEN",
            "state": "NJ",
            "postal_code": "081031088",
            "telephone_number": "848-288-6935",
            "fax_number": "732-790-0107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 COOPER PLZ DEPT OF",
            "city": "CAMDEN",
            "state": "NJ",
            "postal_code": "081031461",
            "telephone_number": "856-342-2425"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "51 N 39th St",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191042640",
            "country_code": "US",
            "telephone_number": "215-662-8244",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PRUDENTE",
        "first_name": "MARK",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-05-24",
        "last_updated": "2024-09-30",
        "certification_date": "2024-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "PA",
            "license": "RN589307",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NJ",
            "license": "26NJ15160500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Camden, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2024; 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.