MARK ANTONIO (CRNA) – Certified Registered Nurse Anesthetist, NPI 1093798886

MARK ANTONIO (CRNA) is a healthcare provider. based in Fairfax, Virginia. specializing in CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA). They hold the professional credentials CRNA. They hold a License No. 39894 (PA). The NPI Number for MARK ANTONIO (CRNA) is 1093798886

Main info

Male
39 Years Of Experience
Accepts Medicare Assignment
Name
MARK ANTONIO (CRNA)
NPI
1093798886
Phone
(703) 295-9360
Address
3998 FAIR RIDGE DR
Enumeration Date
25 November 2005
Last Update Date
6 April 2015

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5709697355
Graduation Year
1987 (39 years ago)
PAC ID
9537101456
Group Practice PAC ID
5395657001
Professional Enrollment ID
I20050601000374
Address ID
PA185102369SC1800XSTXX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

4,245 CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA) in PA

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Provider Addresses for MARK ANTONIO (CRNA)

  • Fifty West, 3998, Fair Ridge Drive, Pender, Fair Oaks, Fairfax County, Virginia, 22033, United States

    SUITE 300

    FAIRFAX, VA 220332921

    Phone: (703) 295-9360

    Fax: (703) 766-9725

    Type: Mailing

  • Regional Hospital of Scranton, 746, Jefferson Avenue, Hill Section, Scranton, Lackawanna County, Pennsylvania, 18510, United States

    SCRANTON, PA 185101624

    Phone: (570) 346-7797

    Fax: (570) 342-9802

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

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: 2005-06-01

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
I20050601000374ICertified Registered Nurse Anesthetist (Crna)PATBD

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 22033)

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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: 5395657001View full group profile

Reviews

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Frequently asked questions

How is MARK ANTONIO (CRNA) identified in CMS data?
CMS-hosted NPPES data lists MARK ANTONIO (CRNA) with NPI 1093798886.
Does CMS list MARK ANTONIO (CRNA) as active?
Yes — MARK ANTONIO (CRNA) is active in the NPI listing used on this page.
What is MARK ANTONIO (CRNA)'s primary classification?
Certified Registered Nurse Anesthetist is the headline specialty for MARK ANTONIO (CRNA) here. Clinical services aligned with this taxonomy classification.
Does MARK ANTONIO (CRNA) list a practice location?
Patients near Fairfax, Virginia may find MARK ANTONIO (CRNA) in results; validate coverage separately.
Why does MARK ANTONIO (CRNA) have multiple addresses?
2 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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