Mary E Koterba, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

209006248 Issued in IL

Practice address

3301 Broadway St
Quincy, IL 62301-3713

Phone

(217) 222-6550

NPI assigned

Jan 16, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Northstar Anesthesia of Illinois, LLCGroup PAC ID 4688893878, 404 clinicians

North American Partners in Anesthesia Illinois LLCGroup PAC ID 1052576519, 431 clinicians

Hospital and Medical Foundation of Paris IncGroup PAC ID 7315933827, 123 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Anthonys Memorial Hospital Hospital, Effingham, IL, CCN 140032
• Paris Community Hospital Hospital, Paris, IL, CCN 141320
• Memorial Hospital of Carbondale Hospital, Carbondale, IL, CCN 140164

Merit-based Incentive Payment System (MIPS)

Final score

91.05 of 100Reported as apm

Quality

72.1

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mary.koterba.1@11356.direct.athenahealth.com

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 & Medical Foundation of Paris, Inc.

  • Critical Access Hospital
  • Paris, IL
  • NPI 1679502322
  Medicare reassignment Care Compare group NPD
• North American Partners in Anesthesia (Illinois), LLC

  • Anesthesiology Physician
  • Oak Park, IL
  • NPI 1699032524
  Medicare reassignment Care Compare group NPD
• Northstar Anesthesia of Illinois, LLC

  • Anesthesiology Physician
  • Arlington, TX
  • NPI 1962822395

  IL, Nurse Anesthetist, Certified Registered

  Medicare reassignment Care Compare group NPD
• St Anthonys Memorial Hospital of the Hospital Sisters of the Third

  • General Acute Care Hospital
  • Effingham, IL
  • NPI 1306800602
  Medicare reassignment NPD
• Hospital & Medical Foundation of Paris, Inc.

  • Rural Health Clinic/Center
  • Chrisman, IL
  • NPI 1447314653
  NPD
• St Anthonys Memorial Hospital of the Hospital Sisters of the Third

  • Clinic/Center
  • Effingham, IL
  • NPI 1881214104
  NPD
• Spectrum Health Primary Care Partners

  • Internal Medicine Physician
  • Grand Rapids, MI
  • NPI 1235188673
  NPD
• Hospital & Medical Foundation of Paris, Inc.

  • Clinic/Center
  • Paris, IL
  • NPI 1629280367

  Nurse Anesthetist, Certified Registered

  NPD (past)
• Lake of the Ozarks Pain Management Services, Inc

  • Specialist
  • Osage Beach, MO
  • NPI 1003901976

  Nurse Anesthetist, Certified Registered

  NPD (past)
• Lake Ozark Anesthesia & Associates, Inc

  • Specialist
  • Osage Beach, MO
  • NPI 1184719049
  NPD (past)

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

• Hospital & Medical Foundation of Paris, Inc.

  • Critical Access Hospital
  • Paris, IL
  • NPI 1679502322
  Care Compare affiliation
• Southern Illinois Hospital Services

  • General Acute Care Hospital
  • Carbondale, IL
  • NPI 1093801797
  Care Compare affiliation
• St Anthonys Memorial Hospital of the Hospital Sisters of the Third

  • General Acute Care Hospital
  • Effingham, IL
  • NPI 1306800602
  Care Compare affiliation
• St Anthonys Memorial Hospital of the Hospital Sisters of the Third

  • Clinic/Center
  • Effingham, IL
  • NPI 1881214104

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1137369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613433600000",
    "number": "1699754820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1025 MAINE ST",
            "city": "QUINCY",
            "state": "IL",
            "postal_code": "623014096",
            "telephone_number": "217-222-6550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3301 BROADWAY ST",
            "city": "QUINCY",
            "state": "IL",
            "postal_code": "623013713",
            "telephone_number": "217-222-6550"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "900 Peeler St",
            "address_purpose": "LOCATION",
            "city": "Kalamazoo",
            "state": "MI",
            "postal_code": "490082300",
            "country_code": "US",
            "telephone_number": "269-345-8618",
            "fax_number": "269-345-1508",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOTERBA",
        "first_name": "MARY",
        "middle_name": "E",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-16",
        "last_updated": "2021-02-16",
        "certification_date": "2021-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MO",
            "license": "118799",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MI",
            "license": "4704351565",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IL",
            "license": "209006248",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MI LICENSE",
            "identifier": "4704351565",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "915820112",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Leslie Anne Koetters, RN
• Daniel Koh, MD
• Shalu Koickal
• Amelia Kolthoff
• Loree Jean Korb, MS, CCC -SLP
• Edith Koutone Edou, MD
• David M Kragel, M.D.
• Steven Krause, D.O.
• Courtney Kroeger, MSW, LCSW
• Melissa Kroeschel, COTA

• Certified Registered Nurse Anesthetist in Quincy, IL
• Providers in Quincy, IL by specialty
• Certified Registered Nurse Anesthetist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2021; 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.