MARK R. DVORAK (NPI# 1699750661) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699750661 |
| Entity Type | Individual |
| Full Name | MARK R. DVORAK |
| Credential | CRNA |
| Practice Address |
N2950 State Road 67 Lake Geneva WI 53147-2655 |
| Practice Telephone | 2622454990 |
| Practice Fax Number | 2622452248 |
| Mailing Telephone | 2622454990 |
| Mailing Fax Number | 2622452248 |
| Enumeration Date | 2005-12-13 |
| Last Update Date | 2016-06-13 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363L00000X | Nurse Practitioner | 1149-33 | WI | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 367500000X | Nurse Anesthetist, Certified Registered | 104604-030 | WI | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | MERCYCARE INSURANCE | DVORAMAR | 01 |
| WI | 1699750661 | 05 | |
| RAIL ROAD MEDICARE | 430067408 | 01 | |
| WI | 43372600 | 05 |
| Street Address |
N2950 STATE ROAD 67 |
| City | LAKE GENEVA |
| State | WI |
| Zip Code | 53147-2655 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386631281 | Shweta Pearlstein | Anesthesiology | N2950 State Road 67, Lake Geneva, WI 53147-2655 | 2005-10-05 |
| 1154928547 | Jessica M Grubb | Occupational Therapist | N2950 State Road 67, Lake Geneva, WI 53147-2655 | 2020-10-08 |
| 1063072650 | Madalyn R Douglas | Physical Therapist | N2950 State Road 67, Lake Geneva, WI 53147-2655 | 2019-06-17 |
| 1013421908 | Ashley E. Boro | Occupational Therapist | N2950 State Road 67, Lake Geneva, WI 53147-2655 | 2017-11-30 |
| 1447776950 | Stefanie N Droese | Physical Therapist | N2950 State Road 67, Lake Geneva, WI 53147-2655 | 2017-08-16 |
| 1427573773 | Andrea M. Lysaght | Registered Nurse | N2950 State Road 67, Lake Geneva, WI 53147-2655 | 2017-08-08 |
| 1265956288 | Kyle C. Janicke | Physical Therapist | N2950 State Road 67, Lake Geneva, WI 53147-2655 | 2017-08-01 |
| 1164952891 | Carling M. Johns | Physical Therapist | N2950 State Road 67, Lake Geneva, WI 53147-2655 | 2017-06-15 |
| 1730615030 | Deborah Lynn Young | Registered Nurse | N2950 State Road 67, Lake Geneva, WI 53147-2655 | 2017-05-04 |
| 1386180255 | Shelly M Weis | Physical Therapist | N2950 State Road 67, Lake Geneva, WI 53147-2655 | 2017-01-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356951206 | Emily Tanis | Physical Therapist | 6722 Wi-50, Lake Geneva, WI 53147 | 2020-08-05 |
| 1588295653 | Baylee M Noe | Occupational Therapy Assistant | Sage Meadow of Lake Geneva 6722 Wi-50, Lake Geneva, WI 53147 | 2020-01-28 |
| 1124539556 | Roxanne Weber | Registered Nurse | 146 E. Geneva Square, Lake Geneva, WI 53147 | 2017-10-12 |
| 1386969400 | Emily Kathleen Wilczak | Surgery | N2950 Wi-67, Lake Geneva, WI 53147 | 2010-03-31 |
| 1538294020 | Dale Alan Miller | Pharmacist | 2950 St. Hwy. 67, Lake Geneva, WI 53147 | 2007-02-23 |
| 1689779902 | Balistreri & Associates Physical Therapy | Physical Therapist | 902 Wells Street, Lake Geneva, WI 53147 | 2006-09-13 |
| 1336157981 | Nestor C Alabarca | Internal Medicine | 146 E Geneva Square, Lake Geneva, WI 53147 | 2006-08-03 |
| 1144259375 | Kim M. Cuculi | Occupational Therapist | 800 Geneva Pkwy N Ste 3, Lake Geneva, WI 53147 | 2006-07-01 |
| 1396253571 | Amar Y. Patel | Family Medicine | 146 E Geneva Sq, Lake Geneva, WI 53147 | 2018-01-22 |
| 1679017925 | Christina L. Clancy | Nurse Practitioner | 146 E Geneva Sq, Lake Geneva, WI 53147 | 2016-12-06 |
| Find all providers in zip 53147 | ||||
| Taxonomy Code | 367500000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Anesthetist, Certified Registered |
| (1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, provides preoperative, intraoperative, and postoperative care to patients and assists in management and resuscitation of critical patients in intensive care, coronary care, and emergency situations. Nurse anesthetists are certified following successful completion of credentials and state licensure review and a national examination directed by the Council on Certification of Nurse Anesthetists. (2) A registered nurse who is qualified by special training to administer anesthesia in collaboration with a physician or dentist and who can assist in the care of patients who are in critical condition. |
| Notes: Sources: (1) Council on Certification of Nurse Anesthetists, Park Ridge, IL, and Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. (2) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 548. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154943637 | Michael Poeschel | Nurse Anesthetist, Certified Registered | 2109 E Capitol Dr Ste B, Appleton, WI 54911-8726 | 2020-05-07 |
| 1285148643 | River Valley Anesthesia, Inc. | Nurse Anesthetist, Certified Registered | 130 S. Knowles Ave., New Richmond, WI 54017 | 2017-11-21 |
| 1295278356 | Braden Williams | Nurse Anesthetist, Certified Registered | 955 Pheasant Creek Dr, Oshkosh, WI 54904 | 2016-11-22 |
| 1396287447 | Dee Cha | Nurse Anesthetist, Certified Registered | 4851 Rachel Ln Apt 5, Wausau, WI 54401 | 2016-11-07 |
| 1053790972 | Rest Assured Anesthesia Services LLC | Nurse Anesthetist, Certified Registered | 1200 John Q Hammons Dr Ste 102, Madison, WI 53717-1967 | 2015-05-26 |
| 1205223898 | Petagaye Tm Johnson | Nurse Anesthetist, Certified Registered | 5150 E Cheryl Pkwy Unit 301, Fitchburg, WI 53711-7659 | 2015-04-21 |
| 1568851194 | Nicholas Joseph Nuccio | Nurse Anesthetist, Certified Registered | 720 S Marquette St, #302, Racine, WI 53403-1174 | 2015-01-20 |
| 1285030452 | Garner Anesthesia Services LLC | Nurse Anesthetist, Certified Registered | 254 E Marquette St, Berlin, WI 54923-1298 | 2014-11-14 |
| 1073934048 | Lynne M Krebs Crna Sc | Nurse Anesthetist, Certified Registered | W178n9912 Rivercrest Dr Ste 102, Germantown, WI 53022-4645 | 2013-12-18 |
| 1831537679 | Roxanne Brault | Nurse Anesthetist, Certified Registered | 7929 S 66th St, Franklin, WI 53132-9281 | 2013-06-13 |
| Find all providers with the same taxonomy | ||||
| City | LAKE GENEVA |
| Zip Code | 53147 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.