Individual provider Active NPI

Mark Alan Schroeder, CRNA

  • Certified Registered Nurse Anesthetist
  • Tulsa, OK
National Provider Identifier
1861540858
Registry record updated Jan 30, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
61134 Issued in OK
Practice address
6901 S Olympia Ave
Tulsa, OK 74132-1843
Phone
(918) 388-5701
NPI assigned
Jan 8, 2007
Last updated
Jan 30, 2014By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 30, 2014

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 61134 OK Primary

Addresses

Primary practice location

6901 S Olympia Ave
Tulsa, OK 74132-1843

Mailing address

4500 S Garnett Rd Ste 300
Tulsa, OK 74146-5238
Phone (918) 392-2944

Other identifiers 1

IdentifierTypeStateIssuer
100787870AMedicaidOK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
61134OKMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Olympia Anesthesia, PLC CurrentSince Nov 17, 2011 Accepting new patients
Anesthesia Associates of Oklahoma PLLC CurrentSince Nov 1, 2010 Accepting new patients
Emporia Anesthesia Associates PA Nurse Anesthetist, Certified Registered PastSince Feb 21, 2021 Accepting new patients
Anesthesiologists of Bartlesville Past Accepting new patients

Locations

4200 E Skelly Dr
Ste 100
Tulsa, OK 74135
Phone (918) 728-6010

6901 S Olympia Ave
Tulsa, OK 74132
Phone (918) 388-5701

735 N Foreman St
Vinita, OK 74301
Phone (918) 256-7551

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

NPI Registry JSON

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

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1391040000000",
    "number": "1861540858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4500 S GARNETT RD STE 300",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741465238",
            "telephone_number": "918-392-2944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6901 S OLYMPIA AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741321843",
            "telephone_number": "918-388-5701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHROEDER",
        "first_name": "MARK",
        "middle_name": "ALAN",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-08",
        "last_updated": "2014-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "OK",
            "license": "61134",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100787870A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.