Individual provider Active NPI

Mary Karen Wyandt, CRNA

  • Certified Registered Nurse Anesthetist
  • Scranton, PA
National Provider Identifier
1922085257
Registry record updated Mar 19, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
035305 Issued in PA
Practice address
746 Jefferson Ave
Scranton, PA 18510-1624
Phone
(570) 346-7797
Fax
(570) 342-9802
NPI assigned
Dec 28, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2015

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 035305 PA Primary

Addresses

Primary practice location

746 Jefferson Ave
Scranton, PA 18510-1624

Mailing address

3998 Fair Ridge Drive
Suite 300
Fairfax, VA 22033-2921
Phone (703) 295-9360

Other identifiers 1

IdentifierTypeStateIssuer
430014722OtherPARR MEDICARE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050602000697 PA Practitioner - Certified Registered Nurse Anesthetist (Crna) 6709829591 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ultracare Anesthesia Partners LLCGroup PAC ID 4082920525, 78 clinicians

Practice addresses (Care Compare)

200 Mifflin Ave
Scranton, PA 18503-1982
Phone (570) 342-3145

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
035305PAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Centurion Anesthesia Penn LLC CurrentSince Dec 27, 2024 Accepting new patients
North American Partners in Anesthesia, Pennsylvania , LLC Nurse Anesthetist, Certified Registered CurrentSince Dec 1, 2012 Accepting new patients

Locations

200 Broadway
Ste 3149
Brooklyn, NY 11211

1685 Valley Center Pkwy
Unit 200
Butztown, PA 18017
Phone 91768149632278

206 E Brown St
East Stroudsburg, PA 18301
Phone (570) 420-4951

746 Jefferson Ave
Scranton, PA 18510
Phone (570) 340-5079

700 Quincy Ave
Scranton, PA 18510
Phone (570) 340-2100

200 Mifflin Ave
Scranton, PA 18503
Phone (570) 342-3145

404 2nd Street Pike
Southampton, PA 18966

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1135728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1426723200000",
    "number": "1922085257",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3998 FAIR RIDGE DRIVE",
            "address_2": "SUITE 300",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220332921",
            "telephone_number": "703-295-9360",
            "fax_number": "703-766-9725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "746 JEFFERSON AVE",
            "city": "SCRANTON",
            "state": "PA",
            "postal_code": "185101624",
            "telephone_number": "570-346-7797",
            "fax_number": "570-342-9802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYANDT",
        "first_name": "MARY KAREN",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-28",
        "last_updated": "2015-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "PA",
            "license": "035305",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "430014722",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Scranton, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2015; 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.