Individual provider Active NPI

Stacey Martz, CRNA

  • Certified Registered Nurse Anesthetist
  • Danville, PA
National Provider Identifier
1760810774
Registry record updated Aug 30, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
RN594705 Issued in PA
Practice address
100 N Academy Ave
Danville, PA 17822-9800
Phone
(570) 271-6211
NPI assigned
Oct 30, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2016

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 RN594705 PA Primary

Addresses

Primary practice location

100 N Academy Ave
Danville, PA 17822-9800

Mailing address

18 Yocum Dr
Bloomsburg, PA 17815-7710
Phone (570) 854-7753

Other identifiers 1

IdentifierTypeStateIssuer
103113047MedicaidPA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140131000018 PA Practitioner - Certified Registered Nurse Anesthetist (Crna) 8123257748 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hazleton Anesthesia Services PCGroup PAC ID 2365584141, 35 clinicians

Practice addresses (Care Compare)

2301 S Broad St
Philadelphia, PA 19148-3542
Phone (215) 952-9936

700 E Broad St
Hazelton, PA 18201-6835
Phone (570) 501-4000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN594705PAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Methodist Associates in Healthcare, Inc Nurse Anesthetist, Certified Registered CurrentSince Jul 11, 2016 Accepting new patients
Hazleton Anesthesia Services, P.C. CurrentSince Sep 1, 2023 Accepting new patients
Northeastern Anesthesia Physicians P.C. CurrentSince Apr 1, 2024 Accepting new patients
Geisinger Clinic CurrentSince Jan 1, 2014 Accepting new patients
Geisinger Clinic Current Accepting new patients
Methodist Associates in Healthcare, Inc Current Accepting new patients
Methodist Associates in Healthcare, Inc CurrentSince Jul 11, 2016 Accepting new patients
Jefferson University Physicians CurrentSince Jul 1, 2019 Accepting new patients
Geisinger Clinic CurrentSince Jan 1, 2014 Accepting new patients

Locations

1736 Hamilton St
Allentown, PA 18104
Phone (610) 770-8300

250 Cetronia Rd
Ste 300
Allentown, PA 18104
Phone (484) 223-2880

24 S 18th St
Allentown, PA 18104
Phone (610) 628-8372

100 N Academy Ave
Danville, PA 17822

700 E Broad St
Hazleton, PA 18201
Phone (570) 501-4000

2128 Blakeslee Boulevard Dr E
Lehighton, PA 18235
Phone (484) 224-9970

111 S 11th St
Philadelphia, PA 19107
Phone (215) 955-6161

2301 S Broad St
Philadelphia, PA 19148
Phone (215) 952-9000

925 Chestnut St
Fl 6
Philadelphia, PA 19107
Phone (215) 955-6760

Organizations & group practices 9

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 & facility affiliations 6

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": "1383091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472515200000",
    "number": "1760810774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 YOCUM DR",
            "city": "BLOOMSBURG",
            "state": "PA",
            "postal_code": "178157710",
            "telephone_number": "570-854-7753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 N ACADEMY AVE",
            "city": "DANVILLE",
            "state": "PA",
            "postal_code": "178229800",
            "telephone_number": "570-271-6211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTZ",
        "first_name": "STACEY",
        "name_prefix": "Miss",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-10-30",
        "last_updated": "2016-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "PA",
            "license": "RN594705",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103113047",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Danville, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2016; 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.