Mark R Dvorak, CRNA is a medicare enrolled "Nurse Anesthetist, Certified Registered" in Lake Geneva, Wisconsin. He graduated from nursing school in 1986 and has 38 years of diverse experience with area of expertise as Certified Registered Nurse Anesthetist (crna). He is a member of the group practice Mercy Health System Corporation, Mercy Health System Corporation and his current practice location is
N2950 State Road 67, Lake Geneva, Wisconsin. You can reach out to his office (for appointments etc.) via phone at
(262) 245-4990.
Mark R Dvorak is licensed to practice in Wisconsin (license number 104604-030) and he also participates in the medicare program. He
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1699750661.
Provider's Profile
| Full Name | Mark R Dvorak |
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| Gender | Male |
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| Speciality | Certified Registered Nurse Anesthetist (crna) |
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| Experience | 38 Years |
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| Location | N2950 State Road 67, Lake Geneva, Wisconsin |
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| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Mark R Dvorak graduated from nursing school in 1986
NPI Data:
- NPI Number: 1699750661
- Provider Enumeration Date: 12/13/2005
- Last Update Date: 06/13/2016
Medicare PECOS Information:
- PECOS PAC ID: 6800924085
- Enrollment ID: I20100507000807
Medical Identifiers
Medical identifiers for Mark R Dvorak such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1699750661 | NPI | - | NPPES |
| 1699750661 | Medicaid | WI | |
| 43372600 | Medicaid | WI | |
| DVORAMAR | Other | WI | MERCYCARE INSURANCE |
| 430067408 | Other | | RAIL ROAD MEDICARE |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 367500000X | Nurse Anesthetist, Certified Registered | 104604-030 (Wisconsin) | Primary |
| 363L00000X | Nurse Practitioner | 1149-33 (Wisconsin) | Secondary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Mercy Health System Corporation | 7416860440 | 475 |
| Mercy Health System Corporation | 7416860440 | 475 |
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. Mark R Dvorak allows following entities to bill medicare on his behalf.
| Entity Name | Mercy Health System Corporation |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1598718603
PECOS PAC ID: 7416860440
Enrollment ID: O20031113000164 |
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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. Mark R Dvorak 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 |
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Mark R Dvorak, CRNA
N2950 State Road 67,
Lake Geneva, WI 53147-2655
Ph: (262) 245-4990 | Mark R Dvorak, CRNA
N2950 State Road 67,
Lake Geneva, WI 53147-2655
Ph: (262) 245-4990 |
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