Individual provider Active NPI

Mark James Padrnos, CRNA

  • Certified Registered Nurse Anesthetist
  • Mount Vernon, WA
National Provider Identifier
1467427351
Registry record updated Jul 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
AP30004443 Issued in WA
Practice address
111 S 13TH St
Mount Vernon, WA 98274-4105
Phone
(360) 336-2178
NPI assigned
Feb 22, 2006
Last updated
Jul 11, 2008By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 11, 2008

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 AP30004443 WA Primary
Registered Nurse 163W00000X RN00107541 WA

Addresses

Primary practice location

111 S 13TH St
Mount Vernon, WA 98274-4105

Mailing address

PO Box 2329
Mount Vernon, WA 98273-7329
Phone (360) 336-6517

Other identifiers 3

IdentifierTypeStateIssuer
0164787OtherWADEPARTMENT OF LABOR AND INDUSTRIES
5032PAOtherWAREGENCE BLUE SHIELD
9609280MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN00107541WAMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Northwest Endoscopy Center, LLC PastSince Oct 17, 2020 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1140566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1215734400000",
    "number": "1467427351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2329",
            "city": "MOUNT VERNON",
            "state": "WA",
            "postal_code": "982737329",
            "telephone_number": "360-336-6517",
            "fax_number": "360-466-2682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 S 13TH ST",
            "city": "MOUNT VERNON",
            "state": "WA",
            "postal_code": "982744105",
            "telephone_number": "360-336-2178"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PADRNOS",
        "first_name": "MARK",
        "middle_name": "JAMES",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-22",
        "last_updated": "2008-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "WA",
            "license": "AP30004443",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WA",
            "license": "RN00107541",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPARTMENT OF LABOR AND INDUSTRIES",
            "identifier": "0164787",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE BLUE SHIELD",
            "identifier": "5032PA",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9609280",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Vernon, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.