Mark D. Reardon, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

RN228961 Issued in MA

Practice address

55 Lake Ave N
Worcester, MA 01655-0002

Phone

(508) 334-3271

Fax

(508) 856-5911

NPI assigned

Jul 28, 2006

Last updated

Nov 25, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in CT, MA2 enrollments

Enrollment records 2

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Anesthesia Associates of Willimantic, PCGroup PAC ID 2163506353, 46 clinicians

Anesthesiologists of Middletown, P.C.Group PAC ID 2769479781, 34 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Middlesex Hospital Hospital, Middletown, CT, CCN 070020
• Windham Community Memorial Hospital Hospital, Willimantic, CT, CCN 070021

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mreardon312703@umassmemorial.direct-ci.com

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.

• Anesthesia Associates of Willimantic PC

  • Anesthesiology Physician
  • Willimantic, CT
  • NPI 1306905799
  Medicare reassignment Care Compare group NPD
• Anesthesiologists of Middletown, P.C.

  • Anesthesiology Physician
  • Middletown, CT
  • NPI 1851317135
  Medicare reassignment Care Compare group NPD
• Woodland Anesthesia Associates PC

  • Anesthesiology Physician
  • Hartford, CT
  • NPI 1437109824
  Medicare reassignment NPD
• Integrated Anesthesia Associates LLC

  • Anesthesiology Physician
  • Shelton, CT
  • NPI 1881636397
  Medicare reassignment
• Umass Memorial Medical Group Inc

  • Internal Medicine Physician
  • Worcester, MA
  • NPI 1760445373
  NPD
• Umass Memorial Medical Group, Inc.

  dba Urgent Care Express at Harrington

  • Urgent Care Clinic/Center
  • Oxford, MA
  • NPI 1982381018
  NPD
• Hartford Anesthesiology Associates, Inc.

  • Anesthesiology Physician
  • Hartford, CT
  • NPI 1336195015

  Nurse Anesthetist, Certified Registered

  NPD (past)
• Milford Anesthesia Associates LLC

  • Anesthesiology Physician
  • Milford, CT
  • NPI 1932152097

  Nurse Anesthetist, Certified Registered

  NPD (past)
• North American Partners in Anesthesia Connecticut PC

  • Anesthesiology Physician
  • New Britain, CT
  • NPI 1316994775
  NPD (past)
• Norwich Anesthesia Associates, PC

  • Anesthesiology Physician
  • Norwich, CT
  • NPI 1114965035
  NPD (past)

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

• Middlesex Hospital

  • General Acute Care Hospital
  • Middletown, CT
  • NPI 1760454334
  Care Compare affiliation
• Windham Community Memorial Hospital, Inc.

  • General Acute Care Hospital
  • Willimantic, CT
  • NPI 1023191467
  Care Compare affiliation

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

{
    "created_epoch": "1154044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606262400000",
    "number": "1518971076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 415348",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022415348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 LAKE AVE N",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016550002",
            "telephone_number": "508-334-3271",
            "fax_number": "508-856-5911"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "111 Founders Plz",
            "address_2": "#300 C/O IPMS",
            "address_purpose": "LOCATION",
            "city": "East Hartford",
            "state": "CT",
            "postal_code": "061083212",
            "country_code": "US",
            "telephone_number": "860-282-4137",
            "fax_number": "860-282-0170",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REARDON",
        "first_name": "MARK",
        "middle_name": "D.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-28",
        "last_updated": "2020-11-25",
        "certification_date": "2020-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MA",
            "license": "RN228961",
            "primary": true
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CT",
            "license": "003046",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110153947A",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004243987",
            "state": "CT"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0978.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "55 Lake Ave N",
            "city": "Worcester",
            "state": "MA",
            "country_code": "US",
            "postal_code": "016550002",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mreardon312703@UmassMemorial.direct-ci.com",
            "affiliation": "N",
            "address_1": "55 Lake Ave N",
            "city": "Worcester",
            "state": "MA",
            "country_code": "US",
            "postal_code": "016550002",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Nirisoa Charonne Razafindralay
• Ready & Ride Transportation Inc
• Readymed Plus Infusion
• Patricia Reagan
• Maria S Reardon, LMHC
• Samantha Lynn Reaves, CNP
• Elaina Rebello, RD, LDN
• Mark Rebello, MSW-CADC
• Matthew R. Rebesco, MD
• Alicia Rebstock

• Certified Registered Nurse Anesthetist in Worcester, MA
• Providers in Worcester, MA by specialty
• Certified Registered Nurse Anesthetist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2020; 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.