Individual provider Active NPI

Mark R Lundgren, CRNA

  • Certified Registered Nurse Anesthetist
  • Rapid City, SD
National Provider Identifier
1700996857
Registry record updated Sep 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
CR000456 Issued in SD
Practice address
353 Fairmont Blvd
Rapid City, SD 57701
Phone
(605) 719-1000
NPI assigned
Aug 30, 2006
Last updated
Sep 24, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X R20994 ND
Certified Registered Nurse Anesthetist 367500000X R045809 SD
Certified Registered Nurse Anesthetist 367500000X CR000456 SD Primary

Addresses

Primary practice location

353 Fairmont Blvd
Rapid City, SD 57701

Mailing address

353 Fairmont Blvd
Atten Medical Staff Services
Rapid City, SD 57701-6000

Other practice location 1

2305 37th Ave SW
Minot, ND 58701-7669
Phone (701) 857-5000

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Cobius Healthcare Solutions

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND, SD2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20040218000893 ND Practitioner - Certified Registered Nurse Anesthetist (Crna) 5193610111 Reassigns benefits to 1 organization
I20050613001006 SD Practitioner - Certified Registered Nurse Anesthetist (Crna) 5193610111 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Trinity HealthGroup PAC ID 7911816020, 292 clinicians

Practice addresses (Care Compare)

101 3Rd Ave SW
Minot, ND 58701-3880
Phone (701) 418-8000

2305 37TH Ave SW
Minot, ND 58701-7669
Phone (701) 418-8000

353 Fairmont Blvd
Rapid City, SD 57701-7375
Phone (605) 755-1000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.05 of 100Reported as group
Quality
60.57
Promoting interoperability
98
Improvement activities
40
Cost
77.93

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R20994NDMDCertified Registered Nurse Anesthetist
CR000456SDMDCertified Registered Nurse Anesthetist
R045809SDMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Trinity Health CurrentSince Sep 7, 2010 Accepting new patients
Monument Health Rapid City Hospital Inc CurrentSince Nov 13, 2017 Accepting new patients
Monument Health Rapid City Hospital, Inc Current Accepting new patients
Monument Health Rapid City Hospital, Inc Nurse Anesthetist, Certified Registered CurrentSince Nov 13, 2017 Accepting new patients
Trinity Health CurrentSince Sep 7, 2010 Accepting new patients

Locations

2720 Dundee Rd
Northbrook, IL 60062
Phone (224) 226-5222

101 3rd Ave SW
Minot, ND 58701
Phone (701) 857-5286

2305 37th Ave SW
Minot, ND 58701
Phone (701) 418-8550

407 3rd St SE
Minot, ND 58701
Phone (701) 857-2000

353 Fairmont Blvd
Rapid City, SD 57701
Phone (605) 719-1000

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 19

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

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758672000000",
    "number": "1700996857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "353 FAIRMONT BLVD",
            "address_2": "ATTEN MEDICAL STAFF SERVICES",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577016000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "353 FAIRMONT BLVD",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "57701",
            "telephone_number": "605-719-1000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2305 37th Ave SW",
            "address_purpose": "LOCATION",
            "city": "Minot",
            "state": "ND",
            "postal_code": "587017669",
            "country_code": "US",
            "telephone_number": "701-857-5000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LUNDGREN",
        "first_name": "MARK",
        "middle_name": "R",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2025-09-24",
        "certification_date": "2025-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "ND",
            "license": "R20994",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "SD",
            "license": "R045809",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "SD",
            "license": "CR000456",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.1068.1",
            "affiliationName": "Cobius Healthcare Solutions",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "2720 Dundee Rd # 302",
            "city": "Northbrook",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600622609",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Rapid City, SD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 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.