Shane Park, CRNA in Oro Valley, AZ - Medicare Nurse Anesthetist, Certified Registered

Shane Park, CRNA is a medicare enrolled "Nurse Anesthetist, Certified Registered" in Oro Valley, Arizona. His current practice location is 1551 E Tangerine Rd, Oro Valley, Arizona. You can reach out to his office (for appointments etc.) via phone at (520) 901-3500.

Shane Park is licensed to practice in Arizona (license number 233774) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1629520127.

Contact Information

	Shane Park, CRNA
	1551 E Tangerine Rd, Oro Valley, AZ 85755-6213
	(520) 901-3500
	Not Available

Map and Direction

Provider's Profile

Full Name	Shane Park
Gender	Male
Speciality	Nurse Anesthetist, Certified Registered
Location	1551 E Tangerine Rd, Oro Valley, Arizona
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1629520127
Provider Enumeration Date: 10/31/2016
Last Update Date: 04/28/2025

Medicare PECOS Information:

PECOS PAC ID: 0749560761
Enrollment ID: I20231108002123

Medical Identifiers

Medical identifiers for Shane Park such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1629520127	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
367500000X	Nurse Anesthetist, Certified Registered	95000619 (California)	Secondary
367500000X	Nurse Anesthetist, Certified Registered	233774 (Arizona)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Shane Park allows following entities to bill medicare on his behalf.

Entity Name	Ias Arizona Pllc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1689359747 PECOS PAC ID: 7517312648 Enrollment ID: O20231010003129

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Shane Park is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Shane Park, CRNA 11234 Anderson St, Loma Linda, CA 92354-2804 Ph: (213) 700-0178	Shane Park, CRNA 1551 E Tangerine Rd, Oro Valley, AZ 85755-6213 Ph: (520) 901-3500

Reviews and Comments

Nurse Anesthetist, Certified Registered Nurses in Oro Valley, AZ

Kimberly Ann Frazier, APRN, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 1551 E Tangerine Rd, Oro Valley, AZ 85755 Phone: 520-901-3500
Erin Mickelson, RN, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 1551 E Tangerine Rd, Oro Valley, AZ 85755 Phone: 520-901-3500
Elizabeth Nadimeh Klaimy, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 1551 E Tangerine Rd, Oro Valley, AZ 85755 Phone: 520-901-3500
Seth Gary, DNP, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 1551 E Tangerine Rd, Oro Valley, AZ 85755 Phone: 520-901-3500
Dereck Vonallman, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 1551 E Tangerine Rd, Oro Valley, AZ 85755 Phone: 520-901-3500
Trezah Clark, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 1551 E Tangerine Rd, Oro Valley, AZ 85755 Phone: 520-901-3500
Murielle Flavie Kameni Ketchandji, CRNA Nurse Anesthetist - CR Medicare: Medicare Enrolled Practice Location: 1551 E Tangerine Rd, Oro Valley, AZ 85755 Phone: 520-901-3500

Shane Park, CRNA - Medicare Nurse Anesthetist, Certified Registered in Oro Valley, AZ