Individual provider Active NPI

Mark Allen Stevenson, CRNA

  • Certified Registered Nurse Anesthetist
  • Boise, ID
National Provider Identifier
1659348233
Registry record updated Oct 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
N-26984 Issued in ID
Practice address
1055 N Curtis Rd
Boise, ID 83706-1309
Phone
(208) 367-6416
Fax
(208) 367-2742
NPI assigned
Mar 2, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 25, 2023

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 N-26984 ID Primary
Certified Registered Nurse Anesthetist 367500000X RNA-950 ID

Addresses

Primary practice location

1055 N Curtis Rd
Boise, ID 83706-1309

Mailing address

PO Box 190930
Boise, ID 83719-0930
Phone (208) 367-6416

Other practice location 1

531 Willow Grove Dr
San Antonio, TX 78245-2776
Phone (210) 680-9378

Other practice location 2

4300 E Flamingo Ave
Nampa, ID 83687-3138
Phone (208) 367-6416

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160329001072 ID Practitioner - Certified Registered Nurse Anesthetist (Crna) 6507914561 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Alphonsus Professional Medical Services LLCGroup PAC ID 7214849751, 124 clinicians

Practice addresses (Care Compare)

1055 N Curtis Rd
Boise, ID 83706-1309
Phone (208) 367-2152

Hospital & facility affiliations

  • Saint Alphonsus Regional Medical Center Hospital, Boise, ID, CCN 130007

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
N-26984IDMDCertified Registered Nurse Anesthetist
RNA-950IDMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Elaine Key MD PLLC CurrentSince Mar 22, 2021 Accepting new patients
St Alphonsus Professional Medical Services LLC CurrentSince Nov 1, 2023 Accepting new patients
St Alphonsus Professional Medical Services LLC CurrentSince Nov 1, 2023 Accepting new patients
Idaho Spine & Pain PLLC CurrentSince May 16, 2021 Accepting new patients
Boise Anesthesia, P a Nurse Anesthetist, Certified Registered CurrentSince Feb 16, 2016 Accepting new patients

Locations

1055 N Curtis Rd
Boise, ID 83706
Phone (208) 367-2152

1859 S Topaz Way
Ste 106
Meridian, ID 83642
Phone (208) 475-3720

4300 E Flamingo Ave
Nampa, ID 83687
Phone (208) 205-1000

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 5

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": "1141257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698192000000",
    "number": "1659348233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 190930",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837190930",
            "telephone_number": "208-367-6416",
            "fax_number": "208-367-2742"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1055 N CURTIS RD",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837061309",
            "telephone_number": "208-367-6416",
            "fax_number": "208-367-2742"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "531 Willow Grove Dr",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "782452776",
            "country_code": "US",
            "telephone_number": "210-680-9378",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4300 E Flamingo Ave",
            "address_purpose": "LOCATION",
            "city": "Nampa",
            "state": "ID",
            "postal_code": "836873138",
            "country_code": "US",
            "telephone_number": "208-367-6416",
            "fax_number": "208-367-2742",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STEVENSON",
        "first_name": "MARK",
        "middle_name": "ALLEN",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-02",
        "last_updated": "2023-10-25",
        "certification_date": "2023-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "ID",
            "license": "N-26984",
            "primary": true
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "ID",
            "license": "RNA-950",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boise, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2023; 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.