Individual provider Active NPI

Mary Kathryn Nentwig, CRNA

  • Certified Registered Nurse Anesthetist
  • Gainesville, FL
National Provider Identifier
1699852210
Registry record updated Feb 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
APRN9496801 Issued in FL
Practice address
1600 SW Archer Rd
Gainesville, FL 32610-3687
Phone
(352) 273-8610
Fax
(352) 273-8612
NPI assigned
Nov 1, 2006
Last updated
Feb 6, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2020

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 RN247765L PA
Certified Registered Nurse Anesthetist 367500000X APRN9496801 FL Primary

Addresses

Primary practice location

1600 SW Archer Rd
Gainesville, FL 32610-3687

Mailing address

PO Box 100254
Gainesville, FL 32610-0254
Phone (352) 273-8610

Other identifiers 1

IdentifierTypeStateIssuer
101904300MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, FL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20090423000231 PA Practitioner - Certified Registered Nurse Anesthetist (Crna) 6103974530 Reassigns benefits to 1 organization
I20190329001061 FL Practitioner - Certified Registered Nurse Anesthetist (Crna) 6103974530 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Professional Anesthesia Services of North America PCGroup PAC ID 1658698824, 49 clinicians

Practice addresses (Care Compare)

1503 N Cedar Crest Blvd
Allentown, PA 18104-2310
Phone (610) 861-8080

2310 Highland Ave
Bethlehem, PA 18020-8920
Phone (610) 861-8080

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
47.54 of 100Reported as apm
Quality
38.49
Promoting interoperability
0
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN9496801FLMDCertified Registered Nurse Anesthetist
RN247765LPAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Clinical Practice Association Inc CurrentSince Jan 23, 2019 Accepting new patients
Florida Clinical Practice Association Inc CurrentSince Jan 23, 2019 Accepting new patients
Professional Anesthesia Services of North America P.C. Nurse Anesthetist, Certified Registered CurrentSince May 1, 2025 Accepting new patients
Professional Anesthesia Services of North America, PC Nurse Anesthetist, Certified Registered Past Accepting new patients

Locations

1600 SW Archer Rd
Gainesville, FL 32610
Phone (352) 265-0077

2001 SW 13th St
Gainesville, FL 32608
Phone (352) 265-8990

2310 Highland Ave
Bethlehem, PA 18020
Phone (610) 691-4300

219 S Balliet St
Frackville, PA 17931
Phone (570) 874-3404

Organizations & group practices 4

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.

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": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580947200000",
    "number": "1699852210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 100254",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326100254",
            "telephone_number": "352-273-8610",
            "fax_number": "352-273-8612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 SW ARCHER RD",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326103687",
            "telephone_number": "352-273-8610",
            "fax_number": "352-273-8612"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NENTWIG",
        "first_name": "MARY",
        "middle_name": "KATHRYN",
        "name_prefix": "Mrs.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-01",
        "last_updated": "2020-02-06",
        "certification_date": "2020-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "PA",
            "license": "RN247765L",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "APRN9496801",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101904300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 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.