Shane Park, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

233774 Issued in AZ

Practice address

1551 E Tangerine Rd
Oro Valley, AZ 85755-6213

Phone

(520) 901-3500

NPI assigned

Oct 31, 2016

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ias Arizona PLLCGroup PAC ID 7517312648, 122 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Tucson Medical Center Hospital, Tucson, AZ, CCN 030006

Merit-based Incentive Payment System (MIPS)

Final score

0 of 100Reported as group

Quality

0

Improvement activities

0

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.

• Ias Arizona PLLC

  • Anesthesiology Physician
  • Tucson, AZ
  • NPI 1689359747
  Medicare reassignment Care Compare group NPD
• Northwest HBP Medical Services LLC

  • Emergency Medicine Physician
  • Tucson, AZ
  • NPI 1407353006
  Medicare reassignment NPD

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

• Tucson Medical Center

  • General Acute Care Hospital
  • Tucson, AZ
  • NPI 1174512792
  Care Compare affiliation

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

{
    "created_epoch": "1477872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745798400000",
    "number": "1629520127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11234 ANDERSON ST",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923542804",
            "telephone_number": "213-700-0178"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1551 E TANGERINE RD",
            "city": "ORO VALLEY",
            "state": "AZ",
            "postal_code": "857556213",
            "telephone_number": "520-901-3500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11234 Anderson Street",
            "address_purpose": "LOCATION",
            "city": "Loma Linda",
            "state": "CA",
            "postal_code": "92354",
            "country_code": "US",
            "telephone_number": "213-700-0178",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PARK",
        "first_name": "SHANE",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-10-31",
        "last_updated": "2025-04-28",
        "certification_date": "2025-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CA",
            "license": "95000619",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "AZ",
            "license": "233774",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Skye Gloria Padilla, M.S. CCC-SLP
• James F Pager, DMD
• Anthony Robert Palmieri, PHARMD
• Angela Maria Paniagua Vega, MD
• Pannado Group LLC
• Gerald William Parks, D.C.
• Areli Parra, LMSW
• Amanda J Partida
• Sabina Pascaru
• Nycole Pataki, PT, DPT

• Certified Registered Nurse Anesthetist in Oro Valley, AZ
• Providers in Oro Valley, AZ by specialty
• Certified Registered Nurse Anesthetist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2025; 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.