Martha M Peck, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

3222 Issued in CA

Practice address

101 The City Dr S
Orange, CA 92868-3201

Phone

(714) 880-7812

NPI assigned

Nov 27, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Mrs. Martha M Cleary Former name

Medicare fee-for-service enrollment

Enrolled in VA, DC2 enrollments

Enrollment records 2

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Old Dominion Anesthesia LLCGroup PAC ID 8820462765, 57 clinicians

Rector and Visitors of the University of VirginiaGroup PAC ID 4789592718, 96 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• University of Virginia Medical Center Hospital, Charlottesville, VA, CCN 490009

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mpeck358662@direct.healthsystem.virginia.edu

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.

• Old Dominion Anesthesia LLC

  • Anesthesiology Physician
  • Charlottesville, VA
  • NPI 1902248677

  DC, Nurse Anesthetist, Certified Registered

  Medicare reassignment Care Compare group NPD
• Rector & Visitors of the University of Virginia

  • General Acute Care Hospital
  • Charlottesville, VA
  • NPI 1780630608
  Medicare reassignment Care Compare group NPD
• Martha Peck Anesthesia Nursing Inc

  • Certified Registered Nurse Anesthetist
  • Monterey Park, CA
  • NPI 1568609683

  VA

  Medicare reassignment Authorized official
• Charlottesville Gastroenterology Associates PC

  • Specialist
  • Charlottesville, VA
  • NPI 1689671448
  Medicare reassignment NPD
• Rector & Visitors of the University of Virginia

  • Community/Retail Pharmacy
  • Charlottesville, VA
  • NPI 1790399202
  NPD
• Rector and Visitors of the University of Virginia

  • Nurse Practitioner
  • Charlottesville, VA
  • NPI 1265560262

  Nurse Anesthetist, Certified Registered

  NPD
• Gastroenterology Associates of Northern Virginia, LLC

  • Gastroenterology Physician
  • Fairfax, VA
  • NPI 1205884368
  NPD (past)

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

• Rector & Visitors of the University of Virginia

  • General Acute Care Hospital
  • Charlottesville, VA
  • NPI 1780630608
  Care Compare affiliation

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

{
    "created_epoch": "1164585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682380800000",
    "number": "1669548244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 S MANCHESTER AVE STE 300",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928683219",
            "telephone_number": "714-456-2986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 THE CITY DR S",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928683201",
            "telephone_number": "714-880-7812"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4100 Olympia Cir Ste 201",
            "address_purpose": "LOCATION",
            "city": "Charlottesville",
            "state": "VA",
            "postal_code": "229113620",
            "country_code": "US",
            "telephone_number": "310-936-0805",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PECK",
        "first_name": "MARTHA",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-27",
        "last_updated": "2023-04-25",
        "certification_date": "2023-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "VA",
            "license": "0024174791",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CA",
            "license": "3222",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARTHA",
            "last_name": "CLEARY",
            "middle_name": "M",
            "prefix": "MRS.",
            "credential": "CRNA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Sharnise Pearson
• Simone Pearson
• Jonathan Michael Peaslee
• Spring Medley Peavy, FNP-C
• Georgie Joven Pechulis, M.D,
• Robert Steven Peck, M.D.
• Pediatric Eye Care & Surgery Medical Corporation
• Pediatric Subspecialty Faculty
• Pediatric Subspecialty Faculty, Inc.
• Pediatric Subspecialty Faculty, Inc.

• Certified Registered Nurse Anesthetist in Orange, CA
• Providers in Orange, CA by specialty
• Certified Registered Nurse Anesthetist in California

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