Individual provider Active NPI

Amy L Marks, CRNA

  • Certified Registered Nurse Anesthetist
  • Fontana, CA
National Provider Identifier
1720289614
Registry record updated Sep 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
NA3091 Issued in CA
Practice address
9961 Sierra Ave
Fontana, CA 92335-6720
Phone
(909) 427-3910
NPI assigned
May 30, 2007
Last updated
Sep 23, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X NA3091 CA Primary

Addresses

Primary practice location

9961 Sierra Ave
Fontana, CA 92335-6720

Mailing address

9961 Sierra Ave
Fontana, CA 92335-6720
Phone (909) 427-3910

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051115001002 CA Practitioner - Certified Registered Nurse Anesthetist (Crna) 3274552617 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2003
Medicare assignment
May accept Medicare assignment
Group practices
Amsurg South Bay Anesthesia LPGroup PAC ID 4082853411, 9 clinicians
Alliance Anesthesia Associates IncGroup PAC ID 8628318318, 4 clinicians

Practice addresses (Care Compare)

23560 Madison St
Torrance, CA 90505-4708
Phone (310) 325-6331

900 S Atlantic Blvd
Monterey Park, CA 91754-4716
Phone (626) 570-9000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
NA3091CAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Amsurg Arcadia Anesthesia LP CurrentSince Mar 15, 2016 Accepting new patients
Alliance Anesthesia Associates Inc Nurse Anesthetist, Certified Registered CurrentSince Sep 7, 2021 Accepting new patients
Amsurg South Bay Anesthesia LP CurrentSince Mar 15, 2016 Accepting new patients

Locations

488 E Santa Clara St
Ste 102
Arcadia, CA 91006
Phone (626) 359-9555

900 S Atlantic Blvd
Monterey Park, CA 91754
Phone (626) 457-7450

23560 Madison St
Torrance, CA 90505
Phone (310) 325-6331

Organizations & group practices 3

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 1

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": "1180483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1222128000000",
    "number": "1720289614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9961 SIERRA AVE",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923356720",
            "telephone_number": "909-427-3910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9961 SIERRA AVE",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923356720",
            "telephone_number": "909-427-3910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARKS",
        "first_name": "AMY",
        "middle_name": "L",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-30",
        "last_updated": "2008-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CA",
            "license": "NA3091",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fontana, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2008; 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.