Individual provider Active NPI

Mark D Plunkett, CRNA

  • Certified Registered Nurse Anesthetist
  • Boardman, OH
National Provider Identifier
1790715936
Registry record updated Aug 21, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
RN235006 Issued in OH
Practice address
7525 California Ave
Boardman, OH 44512-5623
Phone
(330) 758-1954
NPI assigned
Jul 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2007

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 RN235006 OH Primary

Addresses

Primary practice location

7525 California Ave
Boardman, OH 44512-5623

Mailing address

PO Box 182255
Columbus, OH 43218-2255
Phone (614) 430-5724

Other identifiers 2

IdentifierTypeStateIssuer
0534667MedicaidOH
000000139900OtherANTHEM

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070601000007 OH Practitioner - Certified Registered Nurse Anesthetist (Crna) 3971601758 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Triad Health Services LLCGroup PAC ID 9032367917, 252 clinicians

Practice addresses (Care Compare)

7630 Southern Blvd
Youngstown, OH 44512-5633
Phone (330) 729-8000

Hospital & facility affiliations

  • Surgical Hospital at Southwoods Hospital, Youngstown, OH, CCN 360352

Merit-based Incentive Payment System (MIPS)

Final score
83.94 of 100Reported as group
Quality
71.12
Promoting interoperability
100
Improvement activities
40
Cost
75.36

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN235006OHMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Triad Health Services, LLC Nurse Anesthetist, Certified Registered CurrentSince Jan 1, 2021 Accepting new patients
Regional Anesthesia Associates Past Accepting new patients
Pain Center of Western Pennsylvania, Inc Past Accepting new patients
The Surgery Center at Southwoods, LLC Past Accepting new patients

Locations

100 Debartolo Pl
Ste 200
Youngstown, OH 44512
Phone (330) 965-7828

7630 Southern Blvd
Youngstown, OH 44512
Phone (330) 729-8000

7629 Market St
Ste 250
Youngstown, OH 44512
Phone (330) 729-9480

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 and National Provider Directory roles.

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": "1151971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1187654400000",
    "number": "1790715936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 182255",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432182255",
            "telephone_number": "614-430-5724"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7525 CALIFORNIA AVE",
            "city": "BOARDMAN",
            "state": "OH",
            "postal_code": "445125623",
            "telephone_number": "330-758-1954"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PLUNKETT",
        "first_name": "MARK",
        "middle_name": "D",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-04",
        "last_updated": "2007-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "OH",
            "license": "RN235006",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0534667",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000139900",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boardman, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2007; 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.