Individual provider Active NPI

Mario Perez-Pena, CRNA

  • Certified Registered Nurse Anesthetist
  • Baton Rouge, LA
National Provider Identifier
1497214191
Registry record updated Nov 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
202391 Issued in LA
Practice address
100 Womans Way
Baton Rouge, LA 70817-5100
Phone
(225) 924-8149
Fax
(225) 293-1807
NPI assigned
Mar 13, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 202391 LA Primary

Addresses

Primary practice location

100 Womans Way
Baton Rouge, LA 70817-5100

Mailing address

2644 S Sherwood Forest Blvd Ste 121
Baton Rouge, LA 70816-2248
Phone (225) 293-2523

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190409000191 LA Practitioner - Certified Registered Nurse Anesthetist (Crna) 4981945565 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Louisiana Anesthesiology Group L.L.C.Group PAC ID 6507758505, 36 clinicians
Dpi of Louisiana LLCGroup PAC ID 1456886365, 72 clinicians

Practice addresses (Care Compare)

100 Womans Way
Baton Rouge, LA 70817-5100
Phone (225) 468-6070

17000 Medical Ctr Dr
Baton Rouge, LA 70816-3246
Phone (225) 752-2470

Hospital & facility affiliations

  • Womans Hospital Hospital, Baton Rouge, LA, CCN 190128

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
202391LAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
The Capital City Anesthesia Group, LLC Anesthesiology CurrentSince Jul 1, 2019 Accepting new patients
Anesthesiology Group Associates Inc CurrentSince Sep 1, 2022 Accepting new patients
Dpi of Louisiana LLC Anesthesiology CurrentSince Feb 3, 2026 Accepting new patients
St. Tammany Pathology Past Accepting new patients

Locations

11414 Lake Sherwood Ave N
Baton Rouge, LA 70816
Phone (225) 532-4058

5000 Hennessy Blvd
Baton Rouge, LA 70808
Phone (225) 765-4050

9032 Perkins Rd
Baton Rouge, LA 70810
Phone (225) 358-4853

7310 Perkins Rd
Baton Rouge, LA 70808
Phone (225) 236-3100

3600 Florida St
Baton Rouge, LA 70806
Phone (225) 381-2615

8585 Picardy Ave
Baton Rouge, LA 70809
Phone (225) 763-4000

17000 Medical Center Dr
Baton Rouge, LA 70816
Phone (225) 752-2470

7777 Hennessy Blvd
Ste 301
Baton Rouge, LA 70808
Phone (225) 214-6436

Organizations & group practices 5

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.

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": "1552435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573603200000",
    "number": "1497214191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2644 S SHERWOOD FOREST BLVD STE 121",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708162248",
            "telephone_number": "225-293-2523",
            "fax_number": "225-293-1807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 WOMANS WAY",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708175100",
            "telephone_number": "225-924-8149",
            "fax_number": "225-293-1807"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREZ-PENA",
        "first_name": "MARIO",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-13",
        "last_updated": "2019-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "LA",
            "license": "202391",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baton Rouge, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2019; 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.