MARK SISTOSO – Certified Registered Nurse Anesthetist, NPI 1720407752

MARK SISTOSO is a healthcare provider. based in Lawton, Oklahoma. specializing in CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA). They hold a License No. C003258 (AR). The NPI Number for MARK SISTOSO is 1720407752

Main info

Male
13 Years Of Experience
Accepts Medicare Assignment
Name
MARK SISTOSO
NPI
1720407752
Phone
(719) 205-0017
Address
4 NW STONEBROOK DR
Enumeration Date
7 April 2014
Last Update Date
19 September 2018

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4794631000
Graduation Year
2013 (13 years ago)
PAC ID
1658621024
Group Practice PAC ID
6406077460
Professional Enrollment ID
I20180905002591
Address ID
AR727034424FA3215XBLVD500
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience47
Completeness75
Years active:12State licenses:2Digital endpointsOther names

669 CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA) in OK

Provider Addresses for MARK SISTOSO

  • 4 NW STONEBROOK DR

    LAWTON, OK 735059599

    Phone: (719) 205-0017

    Type: Mailing

  • 4301 WILSON ST

    FORT SILL, OK 735034472

    Phone: (719) 205-0017

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 1 Open Payments records for all available years, with a total value of $17.

Total Amount is formed as General ($17) + Research ($0) + Ownership ($0) = $17.

Last reported payment date: 2023-01-25 • Largest payer in this snapshot: Takeda Pharmaceuticals U.S.A., Inc. ($17).

Total Amount

$17

General + Research + Ownership

Payments

1

Total payment records

General Amount

$17

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2023-01-25

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2018-09-05

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20180905002591ICertified Registered Nurse Anesthetist (Crna)ARTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 73505)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 6406077460View full group profile
NameSpecialtyState
Certified Registered Nurse Anesthetist (Crna)MO
Certified Registered Nurse Anesthetist (Crna)AR
Certified Registered Nurse Anesthetist (Crna)AR
Certified Registered Nurse Anesthetist (Crna)MO
Certified Registered Nurse Anesthetist (Crna)AR
A N E S T H E S I O L O G YAR
Certified Registered Nurse Anesthetist (Crna)MO
Certified Registered Nurse Anesthetist (Crna)AR
-AR
-OK

Reviews

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Frequently asked questions

Does MARK SISTOSO share an NPI with anyone else?
NPI numbers are unique to each provider or organization — MARK SISTOSO uses 1720407752.
Is MARK SISTOSO still practicing?
MARK SISTOSO is currently listed as active in the public NPI registry.
What healthcare role does MARK SISTOSO hold?
Scheduling teams often label MARK SISTOSO under Certified Registered Nurse Anesthetist. Clinical services aligned with this taxonomy classification.
Where is MARK SISTOSO based?
MARK SISTOSO is tied to Lawton, Oklahoma in the data we show; additional addresses may exist on the full record.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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