Individual provider Active NPI

Mark E Ruff, CRNA

  • Certified Registered Nurse Anesthetist
  • Springfield, IL
National Provider Identifier
1871555284
Registry record updated Jan 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
209000515 Issued in IL
Practice address
800 E Carpenter St
Springfield, IL 62769-1000
Phone
(217) 544-6464
Fax
(217) 757-6537
NPI assigned
Apr 3, 2006
Last updated
Jan 4, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2022

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 209000515 IL Primary

Addresses

Primary practice location

800 E Carpenter St
Springfield, IL 62769-1000

Mailing address

800 E Carpenter St
Springfield, IL 62769-1000
Phone (217) 544-6464

Other practice location 1

701 N 1st St
Springfield, IL 62781-0001
Phone (217) 788-3754

Other identifiers 2

IdentifierTypeStateIssuer
038222OtherCCNA CERTIFICATION
041199920OtherILRN LICENSE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mruff297182@ewd.direct.hshs.org Direct

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100311000714 IL Practitioner - Certified Registered Nurse Anesthetist (Crna) 4183759491 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
North American Partners in Anesthesia (Illinois), LLC CurrentSince Jun 11, 2022 Accepting new patients
Jacksonville Crnas Inc Nurse Anesthetist, Certified Registered CurrentSince Oct 1, 2010 Accepting new patients
Sangamon Associated Anesthesiologists, S.C. Nurse Anesthetist, Certified Registered Past Accepting new patients
Passavant Memorial Area Hospital Association Past Accepting new patients

Locations

3249 Oak Park Ave
Berwyn, IL 60402
Phone (708) 783-2696

1600 W Walnut St
South Jacksonville, IL 62650
Phone (217) 245-7275

800 E Carpenter St
Springfield, IL 62769
Phone (217) 525-5643

800 E Carpenter St
Rm 2334
Springfield, IL 62769
Phone (217) 525-5643

1305 Walt Whitman Rd
Ste 300
Melville, NY 11747
Phone (516) 370-3796

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": "1144022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641254400000",
    "number": "1871555284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 E CARPENTER ST",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627691000",
            "telephone_number": "217-544-6464",
            "fax_number": "217-757-6537"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 E CARPENTER ST",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627691000",
            "telephone_number": "217-544-6464",
            "fax_number": "217-757-6537"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "701 N 1st St",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "IL",
            "postal_code": "627810001",
            "country_code": "US",
            "telephone_number": "217-788-3754",
            "fax_number": "217-788-7071",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUFF",
        "first_name": "MARK",
        "middle_name": "E",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-03",
        "last_updated": "2022-01-04",
        "certification_date": "2022-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IL",
            "license": "209000515",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CCNA CERTIFICATION",
            "identifier": "038222",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RN LICENSE",
            "identifier": "041199920",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mruff297182@ewd.direct.hshs.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "800 E Carpenter St",
            "city": "Springfield",
            "state": "IL",
            "country_code": "US",
            "postal_code": "627691000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Springfield, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.