Mark Sistoso

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

AP60451158 Issued in WA

Practice address

4301 Wilson St
Fort Sill, OK 73503-4472

Phone

(719) 205-0017

NPI assigned

Apr 7, 2014

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in AR

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Renew Medical Group of Arkansas LTDGroup PAC ID 3173056298, 129 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

Practice roles

Locations

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.

• Renew Medical Group of Arkansas LTD

  • Anesthesiology Physician
  • Fort Smith, AR
  • NPI 1215755947

  Nurse Anesthetist, Certified Registered

  Medicare reassignment Care Compare group NPD
• Anesthesia Services of Benton County PA

  • Anesthesiology Physician
  • Rogers, AR
  • NPI 1013084482
  Medicare reassignment NPD
• Premier Anesthesia of Arkansas Professional Corporation

  • Anesthesiology Physician
  • Fayetteville, AR
  • NPI 1932519485

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Youngs Professional Services LLC

  • Certified Registered Nurse Anesthetist
  • New Iberia, LA
  • NPI 1922178599

  AR, Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Capital Anesthesia Solutions of Arkansas, LLC

  • Anesthesiology Physician
  • Fayetteville, AR
  • NPI 1174125876

  Nurse Anesthetist, Certified Registered

  NPD

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

{
    "created_epoch": "1396828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537315200000",
    "number": "1720407752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 NW STONEBROOK DR",
            "city": "LAWTON",
            "state": "OK",
            "postal_code": "735059599",
            "telephone_number": "719-205-0017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4301 WILSON ST",
            "city": "FORT SILL",
            "state": "OK",
            "postal_code": "735034472",
            "telephone_number": "719-205-0017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SISTOSO",
        "first_name": "MARK",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-07",
        "last_updated": "2018-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "AR",
            "license": "C003258",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "WA",
            "license": "AP60451158",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jonathan Shaffer, DDS
• Susan Ann Shaw, LCSW
• Kathleen Jean Shepard, NP
• Mark Eden Sherman, LCSW
• Tiffany Simmons, DMD
• Moniqua Ann Smiley, RDH
• Jamika Alise Smith, RD
• Wilma Jean Smith, RN, COHN-S
• Daryl Spencer, DDS
• Shannon Marie Stangl, PA-C

• Certified Registered Nurse Anesthetist in Fort Sill, OK
• Providers in Fort Sill, OK by specialty
• Certified Registered Nurse Anesthetist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2018; 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.